Blood test, complete blood count (CBC)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $13
- Cash Discount Price: $83
- vs. Medicare Baseline: 1.67x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $7 - $8 | 90% |
| Medicaid / KanCare | $7 - $13 | 90% |
| Medica Contracted [320239] | $7 | 90% |
| Aetna | $7 - $108 | 90% |
| UnitedHealthcare | $7 - $86 | 90% |
| Blue Cross Blue Shield | $7 - $16 | 90% |
| Halo Hcr Inc Hospice Contracted [320432] | $8 | 103% |
| Cross Timbers Hospice [20098] | $8 | 103% |
| Dept Of Veteran Affairs Contracted [320106] | $8 | 103% |
| Halo Hcr Inc Hospice [20432] | $8 | 103% |
| Elara Caring Aspire Hospice [20433] | $8 | 103% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $8 | 103% |
| Medicare (plans) | $8 | 103% |
| Mercy Hospice Okc [20252] | $8 | 103% |
| Tricare | $8 | 103% |
| Kindful Hospice [20434] | $8 | 103% |
| Pace Of The Ozarks Contracted [320518] | $8 | 103% |
| Kindful Hospice Contracted [320434] | $8 | 103% |
| Health Choice Contracted [320166] | $10 | 129% |
| Ambetter / Centene | $13 | 167% |
| Home State Health Plan Contracted [320187] | $13 | 167% |
| Providrs Care Network Contracted [320484] | $15 | 193% |
| Cigna | $44 - $45 | 566% |
| United Medical Resources Contracted [320454] | $86 | 1107% |
| Yuzu Health Contracted [320521] | $102 | 1313% |
| Imagine 360 Contracted [320494] | $102 | 1313% |
| Mercy Benefit Admin Contracted [320251] | $102 | 1313% |
| Workers Comp [20426] | $102 | 1313% |
| Healthlink Contracted [320179] | $102 | 1313% |
| Auxiant Contracted [320462] | $102 | 1313% |
| American Healthcare Alliance Contracted [320020] | $102 | 1313% |
| Aither Health Contracted [320449] | $102 | 1313% |
| Ebms Contracted [320493] | $102 | 1313% |
| Reflect Health Contracted [320492] | $102 | 1313% |
| Edison Health Solutions Contracted [320502] | $102 | 1313% |
| First Health Contracted [320128] | $108 | 1390% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Mercy Hospital Pittsburg, Inc., the facility's cash median price is $83.00, which is significantly lower than the typical negotiated rates paid by insurance carriers. While the facility's median negotiated rate is $13.00, many commercial payers such as Cigna and United Medical Resources contract with rates reaching $45.00 and $86.00 respectively, and some contracts extend up to $108.00. This disparity highlights that for patients with high-deductible plans, paying the cash price of $83.00 upfront may be more cost-effective than relying on insurance, which often results in higher out-of-pocket costs if the patient's deductible has not yet been met. Additionally, patients should inquire about prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window, bypassing the administrative overhead associated with insurance claims processing.
The facility's pricing structure is benchmarked against federal standards, with a Medicare amount of $7.77 and a vs. Medicare multiplier of 1.7, indicating the negotiated rates are 170% of the Medicare baseline. Although the facility operates as a voluntary non-profit church-owned acute care hospital in Pittsburg, KS, the wide variation in payer contracts—ranging from Medicaid/KanCare plans at $7.00 to specialized hospice and administrative contracts at $102.00—demonstrates the importance of verifying specific plan allowances before scheduling. To ensure transparency and avoid unexpected balance billing, patients are encouraged to request an itemized bill detailing every CPT code