Blood test, complete blood count (CBC)
Facility: St. Catherine Hospital - Garden City
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $25
- Cash Discount Price: $84
- vs. Medicare Baseline: 3.22x 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 322% of the Medicare baseline (a markup of 222%). 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 |
|---|---|---|
| Humana | $8 | 103% |
| Medicare (plans) | $8 | 103% |
| Kansas Health | $8 | 103% |
| Blue Cross Blue Shield | $8 - $25 | 103% |
| Devoted Health | $8 | 103% |
| Innovage | $8 | 103% |
| Kaiser | $8 - $81 | 103% |
| UnitedHealthcare | $8 - $77 | 103% |
| Cigna | $8 - $10 | 103% |
| Aetna | $8 - $104 | 103% |
| Centura Employee Plan | $10 | 129% |
| United Colorado Doctor'S Plan | $12 | 154% |
| Direct To Employer | $14 - $118 | 180% |
| Denver Health | $69 | 888% |
| Wpaa | $87 | 1120% |
| Christian Health Aid | $99 | 1274% |
| Multiplan | $112 - $250 | 1441% |
| Peak Health | $115 | 1480% |
| Health Partners Of Kansas | $120 | 1544% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at St. Catherine Hospital - Garden City, the facility's cash median price of $84.00 is significantly higher than the state average for this service, which is $16.00. While commercial insurance plans like Multiplan and Aetna have negotiated rates ranging from $112 to $104, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly. It is important to note that the Kaiser internal rate of $81 is not a typical negotiated rate and should not be used as a benchmark for comparison. Additionally, the facility's ownership as a voluntary non-profit church organization may influence its pricing structure, but the cash price remains the primary reference point for self-pay patients.
When evaluating the cost relative to Medicare, the facility's negotiated rates average 3.2 times the Medicare amount of $7.77, which aligns with the typical commercial markup range of 200% to 300% seen across the industry. However, patients should be aware that the median negotiated rate of $25.00 is still higher than the cash price, suggesting that bypassing insurance for this specific test could result in lower out-of-pocket costs. To ensure you are receiving the best possible rate, we recommend requesting an itemized billing audit to verify that no unbundled codes or services not rendered are included in your final statement. Furthermore, ask the billing department about prompt-pay discounts, which can reduce the total amount due by 20% to 50% if settled upfront, effectively bypassing the administrative overhead associated with insurance claims processing.