Blood test, complete blood count (CBC)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $20
- Cash Discount Price: $14
- vs. Medicare Baseline: 2.57x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 257% of the Medicare baseline (a markup of 157%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Web Tpa [2115] | $20 | 257% |
| Healthcare Highways [2210] | $20 | 257% |
| Black Lung [6055] | $20 | 257% |
| Aetna | $20 | 257% |
| Oncology Patient Assistance Programs [2295] | $20 | 257% |
| Lucent Health [6000] | $20 | 257% |
| Hooray Health [8000] | $20 | 257% |
| Blue Cross Blue Shield | $20 | 257% |
| Department Of Corrections [1340] | $24 | 309% |
| National Association Of Letter Carriers [1695] | $28 | 360% |
| Cigna | $28 | 360% |
| Humana | $28 | 360% |
| American Postal Workers Union [1070] | $28 | 360% |
| Healthpartners [1500] | $28 | 360% |
| Multiplan [1680] | $37 | 476% |
| First Health [1375] | $37 | 476% |
| American Healthcare [1055] | $37 | 476% |
| Administrative Concepts [1005] | $37 | 476% |
| Coventry Healthcare [1320] | $39 | 502% |
Consumer Guidance & Cost Commentary
For a complete blood count (CBC) test at the University Of Kansas Health System - St Francis Campus in Topeka, the facility's cash median price is $14.00, which is significantly lower than the state average of $48.00. While many insurance plans negotiate a higher rate of $20.00, patients with high-deductible plans may find paying the cash price upfront more cost-effective, as the $14.00 cash rate is well below the negotiated amount. To secure this lower rate, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as billing systems often default to insurance processing once a card is on file. Signing a waiver to prevent automatic claims submission can ensure the facility applies the cash discount rather than processing a claim that would result in a higher out-of-pocket cost.
The facility's negotiated rate of $20.00 aligns with the lowest tier of payers listed, such as Web Tpa and Healthcare Highways, which pay exactly $20.00, while other major carriers like Cigna and Humana also pay $28.00. This pricing structure is notably lower than the facility's gross charge of $48.00, reflecting the standard administrative load and contract dynamics that typically inflate commercial rates. Although the facility is a voluntary non-profit church-owned hospital with a Medicare benchmark of $7.77, the commercial negotiated rates remain above the Medicare amount, illustrating the common markup in commercial healthcare pricing. Consumers are advised to review their specific plan details to confirm whether their deductible has been met before relying on insurance, as paying the full negotiated rate without meeting the deductible could result in higher