CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Lost Rivers Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $52
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 6.69x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Lost Rivers Medical Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 6.69x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $66 (849%)
Insurance Median: $52 (669%)
Cash: $66 (849% of Medicare)
Ins. Median: $52 (669% 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 669% of the Medicare baseline (a markup of 569%). 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
Humana $6 - $52 77%
Regence Blue Shield-All Other Plans $6 77%
Provider Network Of America-All Plans $14 180%
Select Health Brightpath-All Other Plans $47 605%
Tricare $47 605%
Ihcn Brightpath-All Other Plans $50 644%
Va Pccc-All Plans $51 656%
Blue Cross Blue Shield $52 - $83 669%
Ihcn Brightpath Mcr Adv $52 669%
Molina Mcr Adv-All Plans $52 669%
Pacificsource Mcr Adv $52 669%
Regence/Brightpth Slhp Mcr $52 669%
Select Health Mcr Adv $52 669%
Prime Hlth Mcr Adv $55 708%
Aetna $56 - $78 721%
Cigna $77 991%
First Choice-All Plans $77 991%
Pacificsource Navigator-All Other Plans $79 1017%
UnitedHealthcare $79 1017%
Altius Health Plan-All Plans $81 1042%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 551 Highland Drive, Arco, ID 83213
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals