Blood test, complete blood count (CBC)
Facility: Mcpherson Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $96
- Cash Discount Price: $93
- vs. Medicare Baseline: 12.36x 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 1236% of the Medicare baseline (a markup of 1136%). 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 |
|---|---|---|
| Tricare | $7 | 90% |
| Healthy Blue Mcr Adv | $8 | 103% |
| Humana | $8 | 103% |
| UnitedHealthcare | $8 - $155 | 103% |
| Blue Cross Blue Shield | $8 | 103% |
| Va Ccn - All Plans | $8 | 103% |
| Wellcare Mcr Adv - All Plans | $8 | 103% |
| Ambetter / Centene | $9 | 116% |
| Wppa - All Plans | $13 - $108 | 167% |
| Medical Associates - All Plans | $14 - $116 | 180% |
| Central Plains - All Plans | $14 - $116 | 180% |
| Christian Health Aid - All Plans | $15 - $124 | 193% |
| Aetna | $16 - $155 | 206% |
| Multiplan - All Plans | $17 - $140 | 219% |
| Cigna | $18 - $147 | 232% |
| Health Partners - All Plans | $18 - $147 | 232% |
| First Health - All Plans | $18 - $147 | 232% |
| Health Blue Mcaid - All Other Plans | $19 - $158 | 245% |
| Medicaid / KanCare | $19 - $155 | 245% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at McPherson Hospital in McPherson, Kansas, the facility's cash median price is $93.00, which is lower than the state average of $100.00. While commercial insurance plans like Tricare and Healthy Blue Mcr Adv negotiate rates starting at $7.00, many other payers, including UnitedHealthcare and Aetna, have negotiated rates ranging from $8.00 to $155.00. This variation highlights that in-network coverage does not guarantee the lowest price; in cases where a patient has a high deductible or no active coverage, paying the cash price of $93.00 may be more cost-effective than the negotiated rates charged to insured members.
Patients should verify their specific plan's allowed amount before scheduling, as commercial rates can vary significantly by carrier, with some plans paying up to $158.00 for this service. Additionally, the facility offers a prompt-pay discount for self-pay patients who settle their bill upfront, which can further reduce the final cost. It is important to request an itemized bill before paying to ensure all charges are accurate and to avoid summary bills that may obscure individual line items. While the facility's rating is 2 out of 5, the pricing structure remains transparent when comparing the cash rate against the state average and understanding that commercial negotiated rates often include administrative overhead that exceeds the true cost of care.