Blood test, hemoglobin
Facility: Childrens Hospital of Wisconsin
Billing Code: 85018 (CPT)
- CPT Billing Code: 85018
- Insurance Median: $46
- Cash Discount Price: $33
- vs. Medicare Baseline: 19.41x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1941% of the Medicare baseline (a markup of 1841%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $2 - $53 | 84% |
| Chorus Community Health Plan | $2 | 84% |
| My Choice Wisconsin | $2 - $3 | 84% |
| Blue Cross Blue Shield | $3 - $66 | 127% |
| Molina Healthcare of Wisconsin | $3 | 127% |
| Icare | $3 | 127% |
| Managed Health Services | $3 | 127% |
| Froedtert Health | $36 - $59 | 1519% |
| Medical College of Wisconsin | $36 - $49 | 1519% |
| Network Health Plan | $37 - $49 | 1561% |
| Common Ground Healthcare Cooperative | $39 - $59 | 1646% |
| Wps Health Plan | $39 - $63 | 1646% |
| Trilogy Health Solutions | $39 - $59 | 1646% |
| Aspirus Health Plan | $39 - $52 | 1646% |
| Centivo | $40 - $54 | 1688% |
| Health Partners | $40 - $61 | 1688% |
| Advocate Aurora Healthcare | $40 - $54 | 1688% |
| Employer Health Care Alliance Cooperative | $40 - $55 | 1688% |
| Oan LLC | $41 - $56 | 1730% |
| Group Health Cooperative of Eau Claire | $41 - $56 | 1730% |
| Dean Health Plan | $41 - $56 | 1730% |
| Security Health Plan | $43 - $58 | 1814% |
| Quartz Health Insurance | $44 - $59 | 1857% |
| Praire States | $44 - $59 | 1857% |
| Sheboygan Employer's Health Network | $44 - $59 | 1857% |
| Health Payment Systems | $44 - $59 | 1857% |
| Mayo Clinic Health Solutions | $45 - $60 | 1899% |
| Aetna | $45 - $62 | 1899% |
| Bellin Thedacare | $46 - $63 | 1941% |
| Prevea Health Network | $46 - $63 | 1941% |
| Group Health Cooperative of South Central Wisconsin | $46 - $63 | 1941% |
| Cigna | $46 - $63 | 1941% |
| Multiplan | $47 - $66 | 1983% |
| Coventry Health Care | $49 - $66 | 2068% |