CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Adventist Health and Rideout

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $39
Cash Discount Price: $21
vs. Medicare Baseline: 5.02x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Adventist Health and Rideout is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 5.02x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $21 (270%)

Insurance Median: $39 (502%)

Cash: $21 (270% of Medicare)

Ins. Median: $39 (502% 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 502% of the Medicare baseline (a markup of 402%). 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
Bc Mcal	$2	26%
Healthnet Mcal	$6 - $48	77%
Blue Cross Blue Shield	$8 - $183	103%
Kaiser Mcr Adv	$8	103%
Tricare	$8	103%
UnitedHealthcare	$8 - $207	103%
Kaiser Mcal	$9	116%
Medi-Cal	$9	116%
Partnership Hp Mcal -All Plans	$9	116%
Ca Health And Wellness- All Plans	$11	142%
Celtic Mcaid-All Plans	$11	142%
Ah Employee Health Plan - All Plans	$14	180%
Healthnet Comm-All Other Plans	$19 - $143	245%
Aetna	$23 - $168	296%
Kaiser-All Other Plans	$24 - $181	309%
Blue Shield Uc Care Members	$26 - $190	335%
Cigna	$27 - $203	347%
First Health-All Plans	$28 - $208	360%
Phcs-All Plans	$28 - $209	360%
Interplan-All Plans	$29 - $214	373%
Blue Shield-All Other Plans	$31 - $226	399%
Multiplan-All Plans	$31 - $226	399%

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 $21.
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 and Rideout 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.