CMS Price Transparency Data
Blood test, complete blood count (CBC)
Facility: Palmetto General Hospital
Billing Code: 85025 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85025
- Insurance Median: $9
- Cash Discount Price: $501
- vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Palmetto General Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $501. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.16x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$501
Average discount available for prompt cash payment at this facility.
Insurance Median
$9
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: $501 (6448%)
Insurance Median: $9 (116%)
Cash: $501 (6448% of Medicare)
Ins. Median: $9 (116% 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 - $204 | 39% |
| Medicaid / KanCare | $3 - $501 | 39% |
| UnitedHealthcare | $3 - $8 | 39% |
| Cigna | $4 - $251 | 51% |
| Veterans Administration Mill Bill | $5 | 64% |
| Avmed Broad Network | $7 | 90% |
| Medicare (plans) | $7 - $501 | 90% |
| Aetna | $8 - $356 | 103% |
| Bristol Hospice- Miami Dade Llc | $8 | 103% |
| Catholic Hospice | $8 | 103% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $8 | 103% |
| Devoted Health | $8 | 103% |
| Employer Direct Healthcare | $8 - $10 | 103% |
| Healthsun Health Plans | $8 | 103% |
| Hospice Other | $8 | 103% |
| Ima Evalutations Inc | $8 | 103% |
| Leon Health Inc | $8 | 103% |
| Longevity Health Plan | $8 | 103% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $8 | 103% |
| Opuscare Of South Fl | $8 | 103% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $8 | 103% |
| Select Specialty Hospital | $8 | 103% |
| Tricare | $8 | 103% |
| Veterans Administration Vaccn | $8 | 103% |
| Vitas Healthcare Hospice | $8 | 103% |
| Westchester General Hospital | $8 | 103% |
| Bright Health Management Commercial | $9 | 116% |
| Florida Pace Centers | $9 | 116% |
| Imagine Health | $9 | 116% |
| Oscar Health Plan Hix | $9 | 116% |
| Self Pay/Uninsured | $10 | 129% |
| Naphcare Inc | $11 | 142% |
| 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 | $72 | 927% |
| Bc/Bs Of Fl Network Blue | $72 | 927% |
| Bc/Bs Of Fl Simplyblue | $72 | 927% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $77 | 991% |
| Bc/Bs Of Fl Health Options Hmo | $77 | 991% |
| Bc/Bs Of Fl Ppo | $77 | 991% |
| Bc/Bs Of Fl Miami Dade Blue Select | $101 | 1300% |
| Liga Contra El Cancer | $251 | 3230% |
| Bc/Bs Of Fl Phs | $252 | 3243% |
| Magellan Behavioral Health | $301 | 3874% |
| Dimensions International | $326 | 4196% |
| First Health | $336 | 4324% |
| Dimension Health Ppo | $376 | 4839% |
| Beacon Health Strategies Commercial | $501 | 6448% |
| Commercial Non-Contracted | $501 | 6448% |
| Self Pay - Mcd Pending 100 Percent | $501 | 6448% |
| Single Case Agreement | $501 | 6448% |
| United Behavioral Health Psych | $501 | 6448% |