CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Unity Physicians Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $28,559
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3675.55x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Unity Physicians Hospital is $28,559. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 3675.55x the Medicare baseline. Located in 4455 Edison Lakes Pkwy, Mishawaka, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$28,559

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%)

Insurance Median: $28,559 (367555%)

Ins. Median: $28,559 (367555% 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 367555% of the Medicare baseline (a markup of 367455%). 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
Blue Cross Blue Shield	$8 - $44,317	103%
Medicaid / KanCare	$8	103%
Mhs Hoosier Care Connect	$8	103%
Nalc	$61 - $59,888	785%
Sagamore Health Network	$61 - $59,888	785%
Multiplan	$66	849%
Multiplan Wc	$82	1055%
Aarp Supplemental	$28,559	367555%
Aetna	$28,559	367555%
Cigna	$28,559	367555%
Department Of Va	$28,559	367555%
Medicare (plans)	$28,559	367555%
Mhs Healthy Indiana Plan	$28,559	367555%
Railroad Retirement	$28,559	367555%
UnitedHealthcare	$28,559 - $59,888	367555%
Three Rivers Provider Network	$34,271	441068%
Encore	$51,406	661596%
Provider Network Of America	$57,118	735109%
All Savers	$59,888	770759%
Medica	$59,888	770759%
Medica Ifb	$59,888	770759%
Oxford	$59,888	770759%
Humana	$100,000	1287001%

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 $X.
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 Unity Physicians 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.