Blood test, complete blood count (CBC)
Facility: Grisell Memorial Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $20
- Cash Discount Price: $35
- vs. Medicare Baseline: 2.57x 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 257% of the Medicare baseline (a markup of 157%). 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 |
|---|---|---|
| UnitedHealthcare | $3 - $28 | 39% |
| Blue Cross Blue Shield | $13 | 167% |
| Humana | $37 | 476% |
| Medicaid / KanCare | $37 | 476% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at Grisell Memorial Hospital in Ransom, KS, the facility's cash median price is $35.00, which is slightly lower than the state average of $37.00. While the hospital's negotiated rates with major payers like UnitedHealthcare, Blue Cross Blue Shield, and Humana range from $13 to $37, patients should be aware that cash payments can sometimes be more cost-effective if their insurance negotiated rate exceeds the cash price. Given that the facility is a Critical Access Hospital owned by a Government Hospital District, it is advisable to contact the billing department directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can reduce the final amount owed.
To ensure you are not overcharged, it is important to distinguish between the facility's gross charge of $37.00 and the actual amounts paid. The Medicare benchmark for this service is $7.77, which serves as a scientifically validated baseline for the true cost of care; commercial rates are often significantly higher due to administrative overhead and contract dynamics. If you receive a bill that includes unexpected charges or only shows broad category totals, you should request a full itemized audit to identify errors, unbundled codes, or services not rendered. Furthermore, if you are an out-of-network patient receiving care at this in-network facility, the No Surprises Act protects you from balance billing for emergency and non-emergency services, so you should dispute any surprise bills immediately rather than accepting them to avoid credit damage.