Blood test, complete blood count (CBC)
Facility: Valley Children's Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $18
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.32x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 232% of the Medicare baseline (a markup of 132%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Health Net | $8 - $160 | 103% |
| Allcare Ipa | $11 | 142% |
| Central Valley Medical Providers Ipa | $11 - $122 | 142% |
| Dignity Health Central Coast | $11 - $121 | 142% |
| United Physicians Network Ipa | $11 - $17 | 142% |
| Community Health | $12 - $135 | 154% |
| Stanislaus Partners In Health | $12 - $135 | 154% |
| Blue Cross Blue Shield | $13 - $77 | 167% |
| Physicians Choice Medical Group | $13 - $137 | 167% |
| Dignity (Formerly Managed Care Systems) | $14 - $154 | 180% |
| Fowler Packing | $14 - $152 | 180% |
| Health Plan Of San Joaquin | $14 - $147 | 180% |
| Aetna | $15 - $164 | 193% |
| Blue Shield | $15 - $186 | 193% |
| Central California Alliance For Health | $15 | 193% |
| Dignity Ipa_Formerly Img | $15 | 193% |
| Kaiser | $15 - $159 | 193% |
| Kern Legacy | $15 - $159 | 193% |
| La Salle Ipa | $15 | 193% |
| Sante Ipa | $15 | 193% |
| UnitedHealthcare | $15 - $105 | 193% |
| Bakersfield Family Medical Group | $17 - $184 | 219% |
| Community Care Ipa | $17 | 219% |
| First Health Formerly Coventry | $17 - $181 | 219% |
| Network By Design | $17 - $190 | 219% |
| Sequoia Health Ipa | $17 | 219% |
| Univseral Healthcare Ipa | $17 | 219% |
| Community Care Health Plan | $18 - $196 | 232% |
| Health Smart | $18 - $196 | 232% |
| Key Medical Ipa | $18 - $196 | 232% |
| Adventist | $19 | 245% |
| Sutter Health | $19 - $208 | 245% |
| Cencal Health | $22 | 283% |
| Kern Family Health Care | $22 | 283% |
| Multiplan | $22 - $234 | 283% |