CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Atrium Health Navicent Rehabilitation Hopsital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $20
Cash Discount Price: $81
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Atrium Health Navicent Rehabilitation Hopsital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.57x the Medicare baseline. Located in 3351 Northside Dr, Macon, GA.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $81 (1042%)

Insurance Median: $20 (257%)

Cash: $81 (1042% of Medicare)

Ins. Median: $20 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
UnitedHealthcare	$5 - $28	64%
Aetna	$8 - $113	103%
Alliant	$8 - $9	103%
Blue Cross Blue Shield	$8 - $9	103%
Care Source	$8	103%
Clover	$8	103%
Eon Health	$8	103%
Georgia Health Advantage	$8	103%
Humana	$8 - $111	103%
Kaiser	$8 - $28	103%
Pruitt Health	$8	103%
Cigna	$10 - $21	129%
Securehealth	$20 - $57	257%
Ibg	$27 - $115	347%
Ambetter / Centene	$49 - $83	631%
Multiplan	$105 - $130	1351%
Novanet	$130	1673%
Three Rivers Provider Network	$138	1776%
Beechstreet	$151	1943%

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 $81.
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 Atrium Health Navicent Rehabilitation Hopsital 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.