Blood test, complete blood count (CBC)
Facility: Wesley Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $8
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.03x 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 |
|---|---|---|
| Medicaid / KanCare | $7 | 90% |
| Aetna | $7 - $18 | 90% |
| Amerigroup | $7 | 90% |
| UnitedHealthcare | $7 | 90% |
| Triwest Health Alliance | $8 | 103% |
| United | $8 | 103% |
| Devoted Health | $8 | 103% |
| Humana | $8 | 103% |
| Coventry Health Care | $8 | 103% |
| Ambetter / Centene | $8 | 103% |
| Blue Cross Blue Shield | $12 | 154% |
| Correct Care Solutions | $12 | 154% |
| Multiplan | $17 | 219% |
| First Health | $17 | 219% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Wesley Medical Center in Wichita, KS, the facility's negotiated rates range from $7.00 to $8.00 across 14 different insurance plans, with a median negotiated rate of $8.00. This price is consistent with the Medicare benchmark of $7.77, indicating that the facility's commercial rates are aligned with the federal cost baseline rather than inflated by standard chargemaster pricing. While the data does not provide a specific cash or self-pay price for this service, patients with high-deductible plans should be aware that paying cash upfront could potentially result in a lower out-of-pocket cost if the insurance negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer significant fee reductions for upfront payment.
Consumers should be cautious of balance billing, which occurs when a provider bills the difference between their full list price and the insurance allowed amount, often leading to unexpected costs. Although the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, it is important to verify that all ancillary services, such as specific lab components, are covered under the same network agreement. If a patient receives an itemized bill that appears higher than the negotiated rate, they should request a formal itemized audit to identify potential errors, double-billing, or unbundled codes, as over 80% of hospital bills contain inaccuracies. By comparing the facility's rates to the Medicare benchmark and actively seeking prompt-pay options, patients can ensure they are paying a fair and transparent price for their healthcare services.