CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: San Antonio Regional Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $27
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 3.47x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at San Antonio Regional Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 3.47x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $185 (2381%)
Insurance Median: $27 (347%)
Cash: $185 (2381% of Medicare)
Ins. Median: $27 (347% 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 347% of the Medicare baseline (a markup of 247%). 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
Healthnet Medi-Cal $6 77%
Blue Cross Blue Shield $8 - $189 103%
Blue Shield Mcr Adv $8 103%
Caremore Mcr Adv - All Plans $8 103%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $8 103%
Healthnet Mcr Adv $8 103%
Humana $8 103%
Iehp Mcr Adv $8 103%
Inter Valley Hp Mcr Adv- All Plans $8 103%
Kasiser Mcr Adv $8 103%
Kindred Mcr Adv-All Plans $8 103%
Molina Mcr Adv $8 103%
Scan Health Plan Mcr Adv-All Plans $8 103%
Tricare $8 103%
Universal Care - All Plans $8 103%
Zelis Mcr Adv $8 103%
Imperial Health Mcr Adv-All Plans $9 116%
Kaiser Medi-Cal $9 116%
Medi-Cal $9 116%
Aetna $10 - $347 129%
Alpha Care Mg Mcal/Hlthy Kids $10 129%
Choice Phycn Ntwrk Op Only $10 129%
Heritage Prov Ntwrk/Regal Mcal $10 129%
Molina Exchange-All Other Plans $10 129%
Molina Medi-Cal $10 129%
Iehp Comm - All Other Plans $11 142%
Iehp Mcal $12 154%
Redlands Employee $12 154%
Redlands Hmo-All Other Plans $12 154%
Prime Health - All Plans $14 180%
Healthnet - All Other Plans $19 245%
Blue Shield Epn $22 283%
Kaiser Comm - All Other Plans $22 283%
UnitedHealthcare $27 - $201 347%
Cigna $28 360%
Ambetter / Centene $63 811%
Epic Health Plan - All Other Plans $104 1338%
Blue Shield Hmo Pos / Calpers Ppo $128 1647%
Blue Shield Epo Ppo - All Other Plans $139 1789%
Pc Inland Valley Scan $174 2239%
Pc Inland Valley-All Other Plans $174 2239%
Coventry Ccn/First Hlth - All Plans $191 2458%
Choicecare Ntwrk-All Plans $250 3218%
Multiplan/Phcs - All Plans $250 3218%
Networks By Design - All Plans $260 3346%
Zelis Comm-All Other Plans $260 3346%
Foundation Inland Epo-All Other Plans $278 3578%
Foundation Inland Ppo $295 3797%
Health Payors - All Plans $312 4015%
Interplan - All Plans $312 4015%
Wellcare/Easy Choice-All Plans $340 4376%
Alpha Care Mg Mcr Adv $347 4466%
Central Hlth Plan Mcr Adv-All Plans $347 4466%
Epic Health Plan Mcr Adv $347 4466%
Prospect Hp-All Plans $347 4466%
Providence Clevercare Mcr Adv $347 4466%
Heritage Prov Ntwrk/Regal Mcr Adv $352 4530%
Clever Care Mcr Adv - All Plans $364 4685%
La Salle Hp Mcr Adv-All Plans $364 4685%
Providence Oscar-All Other Plans $364 4685%
Alpha Care Mg-All Other Plans $434 5586%
Heritage Prov Ntwrk/Regal - All Other Plans $638 8211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals