Blood test, complete blood count (CBC)
Facility: Stormont Vail Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $11
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.42x 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 |
|---|---|---|
| Blue Cross Blue Shield | $7 - $13 | 90% |
| UnitedHealthcare | $7 | 90% |
| Ambetter / Centene | $7 | 90% |
Consumer Guidance & Cost Commentary
Stormont Vail Hospital in Topeka, KS, offers a complete blood count (CBC) blood test with a cash median price of $184, which is significantly lower than the facility's median negotiated rate of $11180. While the facility is a voluntary non-profit acute care hospital with a 4-star rating, the cash price represents a substantial discount compared to the standard billing process. For patients with high-deductible plans, paying the cash price of $184 upfront could be more cost-effective than relying on insurance, which typically results in a much higher allowed amount.
It is important to note that the facility has no cash median value listed in the provided data, though the gross charge is $184 and the Medicare amount is $7.77. Commercial payers such as Blue Cross Blue Shield, UnitedHealthcare, and Ambetter / Centene have negotiated rates ranging from $7 to $13. Patients should verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these can further reduce out-of-pocket costs. Additionally, if any out-of-network services are rendered, the No Surprises Act may protect patients from balance billing, but consumers should request an itemized audit to ensure all charges are accurate and no unbundled codes or services not rendered have been included.