CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $60
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 7.72x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Saint Joseph Regional Medical Center - Plymouth is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.72x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $79 (1017%)
Insurance Median: $60 (772%)
Cash: $79 (1017% of Medicare)
Ins. Median: $60 (772% 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 772% of the Medicare baseline (a markup of 672%). 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 - $60 51%
Blue Cross Blue Shield $4 - $16 51%
Medicaid / KanCare $4 - $8 51%
UnitedHealthcare $4 - $78 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 - $101 154%
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 - $86 180%
Allied Benefit Systems $15 - $79 193%
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%
Plain Church Group $33 425%
Asr Health Benefits $60 772%
Christian Brother Services $60 772%
Employee Benefit Management $60 772%
Medical Mutual $60 772%
Meritain $60 772%
Preferred One $60 772%
Rural Carrier Health Benefit Plan $60 772%
Webtpa $60 772%
Notre Dame Athletic Association $67 862%
Wc Notre Dame $67 862%
Luminare Health (Detroit) $70 - $73 901%
Ameriben $73 940%
Geha $78 1004%
Healthscope $78 1004%
Student Insurance Cma $78 1004%
Encore Health $86 1107%
Indiana Criminal Justice Inst $86 1107%
Western & Southern Financial Group $86 1107%
Cigna $88 1133%
Group Administrators $88 1133%
Health Partners $88 1133%
Mvp $88 1133%
Prairie States $88 1133%
Priority Health $88 1133%
Professional Benefit Administrators $88 1133%
Sagamore Health Network $88 - $94 1133%
Sisco Benefits $88 1133%
Unified Group Services $88 1133%
Goshen Preferred Network $94 - $105 1210%
Signature Care $101 1300%
Allied National Global Care $110 1416%
Asrm - Reliance Standard Life Insurance $110 1416%
Avmed Health Plan $110 1416%
Christian Care Ministry $110 1416%
Dean Health $110 1416%
Fallon Health $110 1416%
Family Life Insurance Company $110 1416%
Freedom Life Insurance Company $110 1416%
Ghc Scw $110 1416%
International Benefit Administrators $110 1416%
Lifetime Benefit Solutions $110 1416%
Manhattan Life $110 1416%
Medi Share $110 1416%
Multiplan $110 1416%
Pai $110 1416%
Pan-American Life $110 1416%
Paramount Hmo $110 1416%
Phcs $110 1416%
Philadelphia American Life Insurance $110 1416%
Trinity Health Share $110 1416%
Bankers Life Casualty $122 1570%
Bureau Of Disability $122 1570%
Wc Align Network $122 1570%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals