CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Saint Joseph Regional Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $46
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 5.92x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Saint Joseph Regional Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 5.92x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $113 (1454%)
Insurance Median: $46 (592%)
Cash: $113 (1454% of Medicare)
Ins. Median: $46 (592% 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 592% of the Medicare baseline (a markup of 492%). 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
Aetna $4 - $85 51%
Blue Cross Blue Shield $4 - $16 51%
Medicaid / KanCare $4 - $8 51%
UnitedHealthcare $4 - $111 51%
County Coroner $8 103%
Managed Health Services - Indiana $8 103%
Mdwise $8 103%
Medicare (plans) $8 103%
Meridian Complete $8 103%
Pace-Trinity Health $8 103%
Provider Partners Health Plan Of Indiana $9 116%
Auxiant $12 - $144 154%
Caresource $12 154%
Physicians Health Plan Northern Indiana Health Insurance $12 - $23 154%
Siho Insurance Services $12 154%
St Joseph County Hlth Dpt $12 154%
Key Benefit Administrator $14 - $108 180%
Allied Benefit Systems $15 - $113 193%
Blue Benefit Administrators Of Massachusetts $16 206%
Blue Care Network $16 206%
Blue Distinction Transplant $16 206%
Blue Shield - Ca $16 206%
Blue Shield - Id (Regence) $16 206%
Blue Shield - Ny Highmark Northeastern $16 206%
Blue Shield - Ny Highmark Western $16 206%
Blue Shield - Pa (Highmark) $16 206%
Blue Shield - Wa (Regence) $16 206%
Custom Design Benefits $17 219%
Hospice Of Marshall County $45 579%
Hospice Of St Joseph County $45 579%
Plain Church Group $47 605%
Asr Health Benefits $85 1094%
Christian Brother Services $85 1094%
Employee Benefit Management $85 1094%
Medical Mutual $85 1094%
Meritain $85 1094%
Preferred One $85 1094%
Rural Carrier Health Benefit Plan $85 1094%
Webtpa $85 1094%
Notre Dame Athletic Association $96 1236%
Wc Notre Dame $96 1236%
Luminare Health (Detroit) $99 - $104 1274%
Encore Health $103 - $108 1326%
Ameriben $104 1338%
Indiana Criminal Justice Inst $108 1390%
Western & Southern Financial Group $108 1390%
Cigna $111 1429%
Geha $111 1429%
Group Administrators $111 1429%
Health Partners $111 1429%
Healthscope $111 1429%
Mvp $111 1429%
Prairie States $111 1429%
Priority Health $111 1429%
Professional Benefit Administrators $111 1429%
Sagamore Health Network $111 - $129 1429%
Sisco Benefits $111 1429%
Student Insurance Cma $111 1429%
Unified Group Services $111 1429%
Goshen Preferred Network $134 - $150 1725%
Christian Brothers Holy Cross $139 1789%
Signature Care $139 1789%
Bankers Life Casualty $174 2239%
Bureau Of Disability $174 2239%
Wc Align Network $174 2239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals