CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Adventist Health Vallejo

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $116
Cash Discount Price: $38
vs. Medicare Baseline: 14.93x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Adventist Health Vallejo is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 14.93x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $38 (489%)

Insurance Median: $116 (1493%)

Cash: $38 (489% of Medicare)

Ins. Median: $116 (1493% 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 1493% of the Medicare baseline (a markup of 1393%). 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
Blue Shield Mcr Adv	$8	103%
Medicare (plans)	$8	103%
Napa County Mcal Child	$8	103%
Tricare	$8	103%
UnitedHealthcare	$8 - $162	103%
Va Mcr-All Other Plans	$8	103%
Medi-Cal	$9	116%
Va Medi-Cal	$9	116%
Ah Employee Health Plan-All Plans	$14	180%
Healthnet-All Plans	$20	257%
Aetna	$46	592%
Blue Cross Blue Shield	$75 - $90	965%
Blue Shield Behav Hlth	$114	1467%
Blue Shield Non-Epn-All Other Plans	$118	1519%
Blue Shield Epn	$120	1544%
Western Growers-All Plans	$135	1737%
Phcs-All Plans	$140	1802%
Interplan-All Plans	$165	2124%
Choicecare-All Plans	$178	2291%
Beech Street-All Plans	$190	2445%
Cigna	$203	2613%
Kaiser-All Plans	$213	2741%
Health Management Network-All Plans	$216	2780%
Galaxy Network-All Plans	$229	2947%
Three Rivers-All Plans	$229	2947%

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 $38.
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 Vallejo 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.