CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Jefferson County Health Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $39
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 5.02x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Jefferson County Health Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 5.02x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $56 (721%)
Insurance Median: $39 (502%)
Cash: $56 (721% of Medicare)
Ins. Median: $39 (502% 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 502% of the Medicare baseline (a markup of 402%). 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 $7 - $84 90%
Wellmark Hmo $27 347%
Wellmark Indemnity/Ppo - All Other Plans $29 373%
Tricare $36 463%
Amerigroup Mcr Adv $37 476%
Humana $37 476%
Iowa Total Care Comm - All Other Plans $37 476%
Iowa Total Care Mcr $37 476%
Molina Mcr Adv $37 476%
Iowa Total Care Mcaid $39 502%
Molina Mcaid/Chip $39 502%
Medicaid / KanCare $40 515%
Aetna $46 - $84 592%
Medicare (plans) $46 592%
Midlands New Product $76 978%
Coventry Commercial Hmo $79 1017%
Coventry Commercial Ppo - All Other Plans $84 1081%
Midlands Choice-All Other Plans $84 1081%
Molina Marketplace - All Other Plans $93 1197%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals