CMS Price Transparency Data

Blood test, hemoglobin

Facility: St Anthony Community Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $18
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 7.59x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at St Anthony Community Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 7.59x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $39 (1646%)
Insurance Median: $18 (759%)
Cash: $39 (1646% of Medicare)
Ins. Median: $18 (759% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 759% of the Medicare baseline (a markup of 659%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $2 - $3 84%
Affinity By Molina McR $2 84%
Hamaspik (McR) $2 84%
Mvp Gold (McR) $2 84%
Tricare $3 127%
Aetna $4 - $5 169%
Cigna $5 - $27 211%
Emblem Select Care (Exchange) $6 253%
Emblem Ghi/Hip PPO $7 295%
Geisinger Health Commercial/Exchange $8 338%
Magnacare Preferred $9 380%
Mvp Exchange $10 422%
Self-Pay - Cc 30% $12 506%
Blue Cross Blue Shield $18 - $112 759%
Cdphp $20 844%
Mvp Hmo/Ppo $20 844%
Self-Pay $20 844%
Oxford Exchange $20 844%
Self-Pay - Cc 50% $20 844%
UnitedHealthcare $27 1139%
Oxford Commercial $27 1139%
Multiplan $29 1224%
PHCS $29 1224%
Emblem Ghi/Hip Hmo/Epo/Pos $31 1308%
First Health $33 1392%
Mvp $332 - $391 14008%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals