CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Shenandoah Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $53
Cash Discount Price: $103
vs. Medicare Baseline: 6.82x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Shenandoah Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 6.82x the Medicare baseline. Located in 300 Pershing Avenue, Shenandoah, IA.

Cash / Self-Pay

$103

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $103 (1326%)

Insurance Median: $53 (682%)

Cash: $103 (1326% of Medicare)

Ins. Median: $53 (682% 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 682% of the Medicare baseline (a markup of 582%). 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
Blue Cross Blue Shield	$8	103%
UnitedHealthcare	$8 - $155	103%
Home State Health Plan Mcaid-All Plans	$52	669%
Molina Mcd	$52	669%
Nebraska Total Care Mcaid-All Plans	$52	669%
Amerigroup Mcaid-All Plans	$53	682%
Iowa Total Care Mcaid-All Plans	$53	682%
Triwest Wellmark - All Plans	$53	682%
Aetna	$54 - $152	695%
Molina Mcr - All Other Plans	$54	695%
Tricare	$54	695%
Wellcare Mcr Adv - All Plans	$54	695%
Midlands Choice-All Plans	$147	1892%

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 $103.
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 Shenandoah Medical Center 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.