Blood test, complete blood count (CBC)
Facility: Centura St. Catherine-Dodge City
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $49
- Cash Discount Price: $30
- vs. Medicare Baseline: 6.31x 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 631% of the Medicare baseline (a markup of 531%). 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 |
|---|---|---|
| Kansas Health | $8 | 103% |
| Aetna | $8 - $60 | 103% |
| Medicare (plans) | $8 | 103% |
| Kaiser | $8 | 103% |
| Blue Cross Blue Shield | $8 - $16 | 103% |
| Humana | $8 | 103% |
| Cigna | $8 | 103% |
| Centura Employee Plan | $10 | 129% |
| UnitedHealthcare | $49 | 631% |
| Wpaa | $52 | 669% |
| Christian Health Aid | $60 | 772% |
| Multiplan | $60 - $67 | 772% |
| Health Partners Of Kansas | $67 | 862% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Centura St. Catherine-Dodge City, the facility's cash median price is $30.00, which is significantly lower than the state average of $49.00. While many insurance plans negotiate rates ranging from $8 to $67, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and asking for a prompt-pay discount before scheduling. It is important to note that while the facility is in-network for most payers, the negotiated rates can vary widely; for instance, UnitedHealthcare and Wpaa have negotiated rates of $49.00 and $52.00 respectively, whereas Medicare allows a payment of only $7.77. Because insurance billing involves administrative overhead and claim processing costs, the cash price frequently represents a more efficient rate for the patient, provided they secure the discount upfront and avoid automatic claim submission.
The facility's pricing also offers a clear benchmark against federal standards, with the cash median of $30.00 being 387% higher than the Medicare amount of $7.77. This highlights that commercial negotiated rates often include significant markups for administrative services, whereas Medicare rates reflect the true cost of care delivery. Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services like lab tests are billed by out-of-network providers. To ensure transparency, consumers should request an itemized bill before paying and verify that all services rendered are accurately coded, as summary bills may obscure individual line items