CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Fishermen's Community Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $220
  • Cash Discount Price: $253
  • vs. Medicare Baseline: 28.31x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Fishermen's Community Hospital is $220. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 28.31x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$253

Average discount available for prompt cash payment at this facility.

Insurance Median
$220

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: $253 (3256%)
Insurance Median: $220 (2831%)
Cash: $253 (3256% of Medicare)
Ins. Median: $220 (2831% 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 2831% of the Medicare baseline (a markup of 2731%). 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
Aetna $3 - $298 39%
Amerigroup $3 39%
Medicaid / KanCare $3 39%
Sunshine State $3 39%
UnitedHealthcare $3 - $389 39%
Vista $3 39%
Wellcare $3 39%
Blue Cross Blue Shield $65 - $389 837%
Leon Medical $82 1055%
Medica Health Plan $82 1055%
Medicare (plans) $82 - $110 1055%
Humana $89 1145%
Avmed $90 - $322 1158%
Cigna $93 - $311 1197%
Non Contracted $143 1840%
International $253 3256%
Amerihealth $292 3758%
Dimension Health Plan $292 - $350 3758%
Affordable $350 4505%
Phcs $350 4505%
Quality Health $350 4505%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals