CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $68
Cash Discount Price: $80
vs. Medicare Baseline: 8.75x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Clearwater Valley Hospital & Clinics is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 8.75x the Medicare baseline. Located in 301 Cedar Street, Orofino, ID.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $80 (1030%)

Insurance Median: $68 (875%)

Cash: $80 (1030% of Medicare)

Ins. Median: $68 (875% 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 875% of the Medicare baseline (a markup of 775%). 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	$30 - $78	386%
Aetna	$58 - $100	746%
Humana	$58 - $104	746%
Nimiipuu Mcr Adv-All Plans	$58	746%
Pacific Source - All Plans	$58	746%
Regence Blue Shield Mcr	$58	746%
Veterans Amin-All Plans	$58	746%
Corizon Correctnal Med-All Plans	$78	1004%
Cigna	$96	1236%
Idaho Phys Network-All Plans	$102	1313%
Multiplan / Phcs-All Plans	$104	1338%
First Choice-All Plans	$105	1351%
Geha-All Plans	$105	1351%
Regence Blue Shield-All Other Plans	$107	1377%

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 $80.
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 Clearwater Valley Hospital & Clinics 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.