CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Veterans Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $63
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 8.11x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Veterans Memorial Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 8.11x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $83 (1068%)
Insurance Median: $63 (811%)
Cash: $83 (1068% of Medicare)
Ins. Median: $63 (811% 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 811% of the Medicare baseline (a markup of 711%). 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
Wellmark Hmo - All Other Plans $6 77%
Wellmark Ppo $7 90%
Amerigroup Mcaid - All Other Plans $8 103%
Amerigroup Mcr Adv $63 811%
Humana $63 - $110 811%
Iowa Total Care Exchange $63 811%
Iowa Total Care Mcr Adv $63 811%
Medica Mcr Adv $63 811%
Molina Mcr Adv $63 811%
Quartz Mcr Adv $63 811%
UnitedHealthcare $63 - $124 811%
Welmark Mcr Adv $63 811%
Iowa Total Care Mcaid - All Other Plans $74 952%
Molina Mcaid - All Other Plans $74 952%
Quartz Comm - All Other Plans $110 1416%
Medica Comm - All Other Plans $116 1493%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 40 1St Street Se, Waukon, IA 52172
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals