CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $48
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 6.18x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at HSHS St Elizabeth's Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 6.18x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $39 (502%)
Insurance Median: $48 (618%)
Cash: $39 (502% of Medicare)
Ins. Median: $48 (618% 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 618% of the Medicare baseline (a markup of 518%). 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
Molina Healthcare $4 - $54 51%
Meridian Health Plan $5 64%
Aetna $8 - $54 103%
Blue Cross Blue Shield $8 - $54 103%
Clear Spring Health Of Illinois $8 - $54 103%
Health Alliance Medical Plans $8 - $54 103%
Health Partners $8 - $54 103%
Humana $8 - $54 103%
Illinois Breast And Cervical Cancer Program $8 103%
Sae Hospice $8 - $54 103%
UnitedHealthcare $8 - $54 103%
Amish Community $15 193%
Celtic Insurance Company $17 - $54 219%
Naphcare $17 - $54 219%
Claim Doc $19 - $54 245%
Hopetrust $19 - $54 245%
Wellfirst $35 450%
First Health $40 515%
Caterpillar, Inc. $43 553%
Cigna $43 - $54 553%
Healthlink $43 - $54 553%
Consociate Group $48 618%
Choicecare $49 631%
Healthcare Finest Network (Hfn) $49 631%
Multiplan/Phcs $49 631%
Provider Network Of America $49 631%
City Of Springfield $54 695%
Current Health Solutions $54 695%
Healthscope $54 695%
Interplan $54 695%
Live360 $54 695%
Wexford $54 695%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals