Blood test, complete blood count (CBC)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $8
- Cash Discount Price: $34
- 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 |
|---|---|---|
| UnitedHealthcare | $8 - $9 | 103% |
| Providrs Care Network | $8 | 103% |
| Aetna | $8 - $10 | 103% |
| Humana | $8 | 103% |
| Blue Cross Blue Shield | $8 | 103% |
| United Mine Workers Of America | $8 | 103% |
| Lantern Specialty Care | $12 | 154% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Kansas Spine & Specialty Hospital in Wichita, the cash median price is $34.00, which is significantly lower than the facility's negotiated rates of $8.00 and the Medicare benchmark of $7.77. While the facility is owned by a physician group and located in a Kansas Acute Care Hospital setting, patients should note that commercial insurance plans from carriers like UnitedHealthcare, Aetna, and Humana have negotiated rates ranging from $8.00 to $10.00. Because these negotiated rates often exceed the cash price, individuals with high-deductible plans may find it financially advantageous to pay the $34.00 cash median directly, provided they verify that their specific plan does not require a higher out-of-pocket maximum.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. It is important to understand that while the facility's gross charge is $52.00, the actual cost to the patient depends on whether they use insurance or pay cash; commercial contracts often include administrative overhead that inflates the baseline price compared to the true cost represented by the Medicare rate. Before scheduling, verify your deductible status and request a full itemized bill to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute.