CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: John Muir Medical Center - Walnut Creek Campus

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $52
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 6.69x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at John Muir Medical Center - Walnut Creek Campus is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 6.69x the Medicare baseline. Located in 1601 Ygnacio Valley Rd, Walnut Creek, CA.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $96 (1236%)
Insurance Median: $52 (669%)
Cash: $96 (1236% of Medicare)
Ins. Median: $52 (669% 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 669% of the Medicare baseline (a markup of 569%). 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
Contra Costa County Jail [1012104] $7 90%
Aetna $8 - $258 103%
Alignment Health [1177113] $8 103%
Blue Cross Blue Shield $8 - $232 103%
Blue Shield-Network Mcare [1006127] $8 103%
Care 1St Health Plan [1094113] $8 103%
Caremore [1171113] $8 103%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $8 103%
Easy Choice Health Plan [1083113] $8 103%
Essence Healthcare [1049028] $8 103%
Essence Healthcare [1049128] $8 103%
Golden State-Network Mcare [1023127] $8 103%
Health Net-Network Mcare [1028127] $8 103%
Hospice Of East Bay [1085104] $8 103%
Humana $8 - $296 103%
Medicare (plans) $8 - $285 103%
Scan-Network Mcare [1043127] $8 103%
UnitedHealthcare $8 - $209 103%
Veterans Administration [1051113] $8 103%
Jmpn Canopy Hn [1640000011] $9 116%
Generic Commercial/Indemnity [1017001] $10 - $143 129%
Generic Hmo [1018103] $10 129%
Generic Ppo [1021104] $10 129%
Canopy Hn Hmo [1166103] $14 180%
Carecentrix [1011001] $29 - $143 373%
Aps Healthcare [1003103] $32 - $160 412%
Cigna $36 - $255 463%
United Behavioral Health [1048103] $36 - $179 463%
Carelon Behavioral Health [1050104] $39 - $196 502%
Fortified Provider Network [1063104] $39 - $196 502%
Medigap [1036001] $39 - $196 502%
Three Rivers Provider Network [1073104] $39 - $196 502%
Health Net Hmo [1028103] $41 - $203 528%
Health Net-Network [1028026] $41 - $203 528%
Contra Costa Health Plan Hmo [1013103] $43 - $214 553%
Blue Shield Hmo [1006103] $44 - $226 566%
Blue Shield-Network [1006026] $44 - $226 566%
Blue Shield Ppo [1006104] $48 - $262 618%
Western Health Advantage Hmo [1053103] $50 - $285 644%
Health Net Ppo [1028104] $52 - $259 669%
Federal Correction Institute [1062104] $57 - $285 734%
First Health [1016104] $57 - $303 734%
Healthsmart - Pka Interplan [1031104] $57 - $285 734%
National Provider Network/Plancare America [1069104] $57 - $285 734%
Networks By Design [1084104] $57 - $285 734%
Pponext [1072104] $57 - $285 734%
Sutter Preferred Health Plan [1044104] $57 - $285 734%
Kaiser Hmo [1033103] $58 - $289 746%
Health Management Network [1066104] $61 - $303 785%
Healthcomp [1089104] $61 - $303 785%
Galaxy Health Network [1064104] $65 - $321 837%
Integrated Health Plan [1075104] $65 - $321 837%
Brms [1091104] $105 1351%
Delta Health Systems [1032104] $105 1351%
Empire Plan [1092104] $105 1351%
Donor Network West [1008103] $4,000 - $12,000 51480%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1601 Ygnacio Valley Rd, Walnut Creek, CA 94598
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals