CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Madison County Health Care System

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $62
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 7.98x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Madison County Health Care System is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.98x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $77 (991%)
Insurance Median: $62 (798%)
Cash: $77 (991% of Medicare)
Ins. Median: $62 (798% 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 798% of the Medicare baseline (a markup of 698%). 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
Blue Cross Blue Shield $33 - $36 425%
Aetna $41 - $62 528%
Medical Associates Hp - All Plans $41 528%
Medigold-All Plans $41 528%
Tricare $41 528%
UnitedHealthcare $41 - $86 528%
American Hp Mcr Adv-All Plans $43 553%
Iowa Total Care Mcaid-All Plans $45 579%
Molina Mcaid/Chip -All Plans $47 605%
Amerigroup Mcaid-All Plans $48 618%
Madison County Sheriff-All Plans $48 618%
Oscar - All Plans $62 798%
Corvel Wc-All Plans $86 1107%
Choicecare-All Plans $91 1171%
First Choice-All Plans $91 1171%
First Health-All Plans $91 1171%
Integrated Hp-All Plans $91 1171%
Mutual Of Omaha-All Plans $91 1171%
Plaines Health-All Plans $91 1171%
Preferred Hlth Ntwork-All Plans $91 1171%
Principal Healthcare-All Plans $91 1171%
Usa Managed Care-All Plans $91 1171%
Medimore Employee Hp - All Plans $94 1210%
Midlands Choice - All Plans $94 1210%
Benefit Admin Of America-All Plans $96 1236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals