CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: San Gabriel Valley Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $27
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 3.47x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at San Gabriel Valley Medical Center is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 3.47x the Medicare baseline. Located in 438 W Las Tunas Drive, San Gabriel, CA.
Cash / Self-Pay
$81

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: $81 (1042%)
Insurance Median: $27 (347%)
Cash: $81 (1042% 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
Veterans Administration $5 64%
Ahmc Medi-Cal Reciprocity $7 90%
Allied Physicians $7 - $12 90%
Altamed Health Network $7 - $8 90%
Beverly Hospital $7 - $9 90%
Blue Cross Blue Shield $7 - $37 90%
Brand New Day $7 - $103 90%
Emanate Health $7 - $10 90%
Healthnet Medi-Cal Non-Contract $7 90%
Healthy Way La $7 90%
Non Contracting Medi Cal $7 90%
Aetna $8 - $13 103%
Aids Healthcare Foundation $8 - $117 103%
Alignment Health Plan $8 103%
Apa/Aco Inc $8 103%
Avanti $8 - $9 103%
Blue Shield Of California $8 - $109 103%
Central Health Plan $8 - $176 103%
Cv-19 Hrsa Uninsured Testing And Tx $8 103%
Health Net $8 - $170 103%
Health Net Inc $8 - $18 103%
Hollywood Presbyterian Adv Med Mcal $8 103%
Hollywood Presbyterian Medpoint Mcal $8 103%
Humana $8 103%
Inter Valley Health Plan $8 103%
La Care Health Plan $8 103%
Medicaid / KanCare $8 103%
Medicare (plans) $8 103%
Molina Healthcare Of California $8 - $114 103%
Pacific Alliance Medical Center $8 103%
Pacificare Of California $8 - $96 103%
Physicians Healthways $8 103%
Providence Health Network $8 103%
Self-Pay $8 103%
St Vincent Medical Center/Psych $8 103%
Tricare $8 103%
Wellcare $8 103%
Athens Administrators $9 116%
Beech Street $9 - $234 116%
Care 1St Health Plan $9 - $190 116%
Chinatown Service Center Pace $9 116%
Cigna $9 116%
Other Non Contracting Workers Comp $9 116%
Ahmc Health Self-Insurance Epo $10 129%
Knox-Keene Act $10 129%
UnitedHealthcare $16 - $31 206%
Private Pay $23 296%
Ahmc Reciprocity $74 - $88 952%
Alignment Healthplan $86 - $103 1107%
Clever Care $86 - $103 1107%
Pacific Independent Physician Associates $99 - $117 1274%
Facey Medical $124 - $146 1596%
Community Care Network $161 - $190 2072%
Choicecare Network $173 - $205 2227%
Private Healthcare Systems (Phcs) $173 - $205 2227%
Affiliated Health Fund $185 - $220 2381%
Multiplan $222 - $264 2857%
Ppo Next $222 - $264 2857%
Managed Health Network $247 - $293 3179%
Medi-Cal Sub Acute $247 - $293 3179%
One Legacy $247 - $293 3179%
Other Non Contracted Commercial $247 - $293 3179%
Us Behavioral Health Plan $247 - $293 3179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 438 W Las Tunas Drive, San Gabriel, CA 91776
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals