CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: North Shore Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $10
  • Cash Discount Price: $613
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at North Shore Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $613. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.29x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$613

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $613 (7889%)
Insurance Median: $10 (129%)
Cash: $613 (7889% of Medicare)
Ins. Median: $10 (129% 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.

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
Humana $3 - $244 39%
Medicaid / KanCare $3 - $613 39%
UnitedHealthcare $3 - $8 39%
Cigna $4 - $306 51%
Veterans Administration Mill Bill $5 64%
Avmed Broad Network $7 90%
Medicare (plans) $7 - $613 90%
Aetna $8 - $441 103%
Devoted Health $8 103%
Employer Direct Healthcare $8 - $10 103%
Healthsun Health Plans $8 103%
Hospice Other $8 103%
Leon Health Inc $8 103%
Longevity Health Plan $8 103%
Tricare $8 103%
Veterans Administration Vaccn $8 103%
Bright Health Management Commercial $9 116%
Florida Pace Centers $9 116%
Imagine Health $9 116%
Oscar Health Plan Hix $9 116%
Centurion Prison $10 129%
Self Pay/Uninsured $10 129%
Ambetter / Centene $14 180%
Avmed Exchange $14 180%
Dimension Health Wc $14 180%
Workers Compensation $14 180%
Molina Marketplace Program Exchange $15 193%
Auto Insurance $16 206%
Avmed Select Network $16 206%
Amerihealth Caritas Next Exchange $17 219%
Bc/Bs Myblue Hmo Hix $76 978%
Bc/Bs Of Fl Network Blue $81 1042%
Bc/Bs Of Fl Ppo $81 1042%
Bc/Bs Of Fl Simplyblue $81 1042%
Bc/Bs Of Fl Blue Select Exchange Non Par $88 1133%
Bc/Bs Of Fl Health Options Hmo $88 1133%
Bc/Bs Of Fl Phs $318 4093%
Magellan Behavioral Health $368 4736%
Dimensions International $398 5122%
First Health $417 5367%
Dimension Health Ppo $459 5907%
Beacon Health Strategies Commercial $613 7889%
Commercial Non-Contracted $613 7889%
Self Pay - Mcd Pending 100 Percent $613 7889%
Single Case Agreement $613 7889%
United Behavioral Health Psych $613 7889%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals