Blood test, complete blood count (CBC)
Facility: Lane County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $60
- Cash Discount Price: $60
- vs. Medicare Baseline: 7.72x 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 772% of the Medicare baseline (a markup of 672%). 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 |
|---|---|---|
| Aetna | $54 - $57 | 695% |
| UnitedHealthcare | $54 - $60 | 695% |
| Healthy Blue Mcaid | $60 | 772% |
| Healthy Blue Mcr Adv - All Other Plans | $60 | 772% |
| Medicaid / KanCare | $60 - $66 | 772% |
| Wppa Providers-All Plans | $90 | 1158% |
Consumer Guidance & Cost Commentary
For a complete blood count (CBC) at Lane County Hospital in Dighton, KS, the cash price is $60.00, which matches the facility's median negotiated rate and the state average. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $54 to $60, Medicaid plans in the same area pay up to $66. This data indicates that paying cash directly may be the most cost-effective option for patients with high-deductible plans, as the cash price aligns closely with the lowest commercial negotiated rates. Patients should verify if their specific plan has a deductible that would otherwise require them to pay the higher commercial negotiated amount, potentially making the cash price a significant savings.
To maximize your savings, you should proactively ask the hospital about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims. Since the cash price here is already competitive with negotiated rates, requesting a prompt-pay discount could further lower your out-of-pocket expense. Additionally, ensure you receive an itemized bill rather than a summary invoice to confirm that no unexpected charges for services not rendered or unbundled codes are included. Always compare these rates against the local county average to ensure you are receiving fair pricing, as commercial rates often exceed the true cost of care represented by Medicare benchmarks.