CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Decatur County Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $70
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 9.01x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Decatur County Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 9.01x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $70 (901%)
Insurance Median: $70 (901%)
Cash: $70 (901% of Medicare)
Ins. Median: $70 (901% 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 901% of the Medicare baseline (a markup of 801%). 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
UnitedHealthcare $4 - $118 51%
Blue Cross Blue Shield $16 - $44 206%
Champva -All Plans $22 - $63 283%
Everystep Hospice-All Plans $25 - $72 322%
Aetna $26 - $110 335%
Tricare $26 - $75 335%
Benefit Admin System-All Plans $32 - $90 412%
Wellmark Hmo $33 425%
Humana $36 - $101 463%
Meritain Health-All Plans $36 - $101 463%
Misc Commercial-All Plans $36 - $101 463%
Wellmark Ppo - All Other Plans $36 463%
All Savers-All Plans $37 - $104 476%
Allied Benefit System-All Plans $37 - $104 476%
American Family Ins Grp-All Plans $37 - $104 476%
Rural Carrier Benefit Plan-All Plans $38 - $107 489%
Christian Healthcare -All Plans $39 - $111 502%
Medica-All Other Plans $39 - $111 502%
Cigna $42 - $120 541%
Golden Rule-All Plans $42 - $118 541%
Ntca The Rural Broadband-All Plans $42 - $118 541%
Medical Mutual-All Plans $43 - $122 553%
Farm Bureau Financial-All Other Plans $44 - $125 566%
Farm Bureau Property And Ca $44 - $125 566%
Health Partners-All Plans $45 - $128 579%
Medi Share-All Plans $45 - $126 579%
Uhss-All Plans $45 - $126 579%
Lewermark-All Plans $47 - $132 605%
Mail Handlers Benefit-All Plans $48 - $136 618%
Midlands Choice-All Plans $48 - $136 618%
Priority Health-All Plans $49 - $139 631%
Iowa Total Care Mcaid-All Plans $50 - $142 644%
Amerigroup Mcaid-All Plans $51 - $146 656%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals