Blood test, complete blood count (CBC)
Facility: Pratt Regional Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $37
- Cash Discount Price: $28
- vs. Medicare Baseline: 4.76x 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 476% of the Medicare baseline (a markup of 376%). 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 |
|---|---|---|
| Christian Health Aid | $8 - $120 | 103% |
| UnitedHealthcare | $9 - $163 | 116% |
| Health Partners Of Kansas | $9 - $136 | 116% |
| Aetna | $10 - $144 | 129% |
| Choicecare | $11 - $160 | 142% |
Consumer Guidance & Cost Commentary
For a complete blood count (CBC) at Pratt Regional Medical Center in Pratt, KS, the cash price is $28.00, which is lower than the facility's negotiated rates of $37.00 and significantly below the gross charge of $40.00. While the facility's cash rate is higher than the Medicare benchmark of $7.77, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds the cash price. It is important to note that commercial negotiated rates often include administrative overhead and can be inflated compared to the true cost of care represented by Medicare benchmarks.
Before scheduling, patients should verify their specific insurance plan's allowed amount and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50%. Although this report does not provide state or county average data for comparison, patients should be aware that balance billing is generally prohibited for emergency services and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act. If a patient receives a surprise bill, they should request an audit rather than paying immediately, and they should always demand a detailed, itemized statement before agreeing to any payment plan.