CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Modoc Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $108
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 13.90x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Modoc Medical Center is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 13.90x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $125 (1609%)
Insurance Median: $108 (1390%)
Cash: $125 (1609% of Medicare)
Ins. Median: $108 (1390% 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 1390% of the Medicare baseline (a markup of 1290%). 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
Multiplan Wc $7 90%
Integrated Hp Wc $8 103%
Ntwrks By Design Wc - All Plans $8 103%
Adv Med Mgmt - All Plans $9 116%
Medi-Cal $9 116%
Medi-Cal 7/1/24 $9 116%
Partnership Hp - All Plans $9 116%
Blue Shield Mcr Adv $68 875%
Blue Shield Va $68 875%
UnitedHealthcare $68 - $119 875%
Tricare $71 914%
Healthnet Mcr Adv $72 927%
Blue Cross Blue Shield $103 - $114 1326%
Blue Shield Exch $103 1326%
Blue Shield Comm - All Other Plans $114 1467%
Carelon - All Plans $114 1467%
Corvel - All Plans $118 1519%
Aetna $119 1532%
Coventry/First Health - All Plans $119 1532%
Galaxy Health - All Plans $119 1532%
Healthnet Comm - All Other Plans $119 1532%
Hmn - All Plans $119 1532%
Integrated Hp - All Other Plans $119 1532%
Interplan - All Plans $119 1532%
Multiplan - All Other Plans $119 1532%
Superior Ca Ppo - All Plans $119 1532%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 N Nagle Street, Alturas, CA 96101
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals