CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Carle Health Pekin Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $38
Cash Discount Price: $152
vs. Medicare Baseline: 4.89x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Carle Health Pekin Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 4.89x the Medicare baseline. Located in 600 South 13Th Street, Pekin, IL.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $152 (1956%)

Insurance Median: $38 (489%)

Cash: $152 (1956% of Medicare)

Ins. Median: $38 (489% 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 489% of the Medicare baseline (a markup of 389%). 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
Aetna	$6 - $82	77%
Blue Cross Blue Shield	$6 - $64	77%
Humana	$7 - $8	90%
Molina	$8 - $49	103%
UnitedHealthcare	$8 - $23	103%
Wellcare	$8	103%
Meridian	$9	116%
Healthlink	$12	154%
Multiplan/Phcs	$12 - $82	154%
Cigna	$17 - $109	219%

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 $152.
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 Carle Health Pekin Hospital 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.