CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Norton-King's Daughters' Health

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $53
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 6.82x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Norton-King's Daughters' Health is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 6.82x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $15 (193%)
Insurance Median: $53 (682%)
Cash: $15 (193% of Medicare)
Ins. Median: $53 (682% 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 682% of the Medicare baseline (a markup of 582%). 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 $6 - $59 77%
Blue Cross Blue Shield $8 - $24 103%
Humana $8 103%
Managed Health Services $8 - $12 103%
Managed Health Services Of Indiana $8 103%
Managed Health Services Of Kentucky $8 103%
Passport By Molina $8 103%
UnitedHealthcare $8 - $53 103%
Caresource Of Kentucky $11 142%
Caresource Of Indiana $12 154%
Custom Design Benefits $16 - $34 206%
Cigna $57 734%
Encore $57 734%
Bluegrass $60 772%
First Health $60 772%
Healthlink $60 772%
Quality Care Partners $60 772%
Vha/Tristate $60 772%
Multiplan/Phcs $62 798%
Indiana Health Network $64 824%
Siho $64 824%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals