CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Adventist Health St Helena

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $128
Cash Discount Price: $41
vs. Medicare Baseline: 16.47x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Adventist Health St Helena is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 16.47x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)

Cash / Self-Pay: $41 (528%)

Insurance Median: $128 (1647%)

Cash: $41 (528% of Medicare)

Ins. Median: $128 (1647% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 1647% of the Medicare baseline (a markup of 1547%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Shield Bh Mcr Adv	$8	103%
Blue Shield Mcr Adv	$8	103%
Kaiser Mcr Adv	$8	103%
Tricare	$8	103%
UnitedHealthcare	$8 - $176	103%
Va Mcr - All Other Plans	$8	103%
Va Medi-Cal	$9	116%
Ah Employee Health Plan - All Plans	$14	180%
Healthnet-All Plans	$21	270%
Aetna	$46	592%
Blue Cross Blue Shield	$67 - $90	862%
Blue Shield Behav Hlth	$124	1596%
Blue Shield Non-Epn	$128	1647%
Blue Shield Epn-All Other Plans	$130	1673%
Western Growers-All Plans	$146	1879%
Phcs-All Plans	$152	1956%
Interplan-All Plans	$179	2304%
Choicecare-All Plans	$193	2484%
Beech Street-All Plans	$207	2664%
Cigna	$221	2844%
Kaiser-All Other Plans	$226	2909%
Health Management Network-All Plans	$235	3024%
Galaxy Network-All Plans	$248	3192%
Three Rivers-All Plans	$248	3192%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $41.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85025.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.