85018

Blood count, hemoglobin

Medicare pricing data for 18,097 providers across 51 states

🤖AI Overview

This procedure has a 6.1x markup — hospitals charge $14.00 but Medicare allows only $2.31. Uninsured patients may face bills 6.1 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Blood count, hemoglobin (HCPCS code 85018) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2.31, but hospitals typically charge $14.00 — a 6.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.46

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2.31, your out-of-pocket cost would be approximately $0.46. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2.31
Average Hospital Charge
$14.00
Markup Ratio
6.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$14.00
Medicare Allowed$2.31
Medicare Payment$2.31

Hospitals charge 6.1x more than what Medicare allows for this procedure. Medicare actually pays $2.31 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Kansas$2$152065,568+0.4%
Louisiana$2$131182,544+0.4%
Maine$2$1436224+0.4%
Massachusetts$2$1132911,161+0.4%
Montana$2$1542197+0.4%
New Mexico$2$15681,317+0.4%
Oklahoma$2$14721,248+0.4%
Pennsylvania$2$142525,218+0.4%
Rhode Island$2$9381,114+0.4%
South Dakota$2$151121,181+0.4%
Vermont$2$1394380+0.4%
Wyoming$2$1832207+0.4%
Puerto Rico$2$338331+0.4%
Florida$2$1388528,0830.0%
Georgia$2$1280815,4770.0%
Hawaii$2$8171,7660.0%
Illinois$2$185988,2910.0%
Indiana$2$103042,1370.0%
Iowa$2$155045,8520.0%
Kentucky$2$122522,6920.0%
Maryland$2$81034,2460.0%
Michigan$2$112572,0640.0%
Minnesota$2$132,22624,5840.0%
Mississippi$2$192054,4710.0%
Nebraska$2$92294,1990.0%
New Jersey$2$1613814,1880.0%
New York$2$164085,9500.0%
North Carolina$2$161,02535,4960.0%
North Dakota$2$201041,0340.0%
Ohio$2$1537312,0250.0%
Oregon$2$122483,8080.0%
Texas$2$1458626,5430.0%
Utah$2$82551,9740.0%
Virginia$2$1150712,8170.0%
West Virginia$2$20652800.0%
Wisconsin$2$296947,1320.0%
Alabama$2$153049,9210.0%
Colorado$2$182452,1930.0%
Connecticut$2$92811,6270.0%
Delaware$2$517427-0.4%
Nevada$2$10814,935-0.4%
New Hampshire$2$1067343-0.4%
South Carolina$2$136595,880-0.4%
Washington$2$154495,385-0.4%
Arizona$2$152069,674-0.4%
Arkansas$2$91913,149-0.4%
California$2$142,53937,416-0.4%
Missouri$2$93375,543-0.9%
Tennessee$2$143304,758-0.9%
Alaska$2$3266211-0.9%
Idaho$2$1773320-2.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber