Blood test, complete blood count (CBC)
Facility: Kansas City Orthopaedic Institute
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $22
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.83x 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 283% of the Medicare baseline (a markup of 183%). 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 |
|---|---|---|
| Cigna | $8 - $32 | 103% |
| UnitedHealthcare | $8 - $37 | 103% |
| Aetna | $8 | 103% |
| Blue Cross Blue Shield | $14 - $40 | 180% |
| Medica | $33 - $35 | 425% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) procedure at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $8 to $40 across five major payers, with a median negotiated payment of $22.00. This facility is owned by physicians and operates as an acute care hospital. While the data does not provide specific cash or median paid figures for this service, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs, particularly for those with high-deductible plans where the insurance negotiated rate might exceed the cash price. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling care.
The facility's pricing is benchmarked against federal standards, showing a ratio of 2.8 times the Medicare amount of $7.77. Since Medicare rates represent a scientifically validated baseline for the true cost of care, this ratio indicates the commercial pricing structure relative to that standard. Patients should avoid using the hospital's full chargemaster list as a benchmark for savings, as these figures are often inflated. Instead, comparing rates to the Medicare amount provides a clearer picture of the facility's markup. Additionally, if a patient receives a bill that appears to include charges for services not rendered or unbundled components, they should request a formal itemized audit to identify potential errors before making a payment.