Blood test, complete blood count (CBC)
Facility: Mercy Hospital Columbus
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $62
- Cash Discount Price: $55
- vs. Medicare Baseline: 7.98x 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 798% of the Medicare baseline (a markup of 698%). 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 | $7 - $71 | 90% |
| Medicaid / KanCare | $7 - $62 | 90% |
| Blue Cross Blue Shield | $7 - $62 | 90% |
| Humana | $7 - $81 | 90% |
| Medicare (plans) | $8 - $64 | 103% |
| Health Systems Inc Contracted [320174] | $37 | 476% |
| Insurance System Inc Contracted [320465] | $37 | 476% |
| Administrative Payor Contracted [320005] | $38 | 489% |
| Ambetter / Centene | $62 | 798% |
| Halo Hcr Inc Hospice [20432] | $62 | 798% |
| Cigna | $62 | 798% |
| Mercy Mgd Behavioral Health Contracted [320259] | $62 | 798% |
| Mercy Hospice Okc [20252] | $62 | 798% |
| Home State Health Plan Contracted [320187] | $62 | 798% |
| Halo Hcr Inc Hospice Contracted [320432] | $62 | 798% |
| Medical Associates Health Contracted [320444] | $62 | 798% |
| Pace Of The Ozarks Contracted [320518] | $62 | 798% |
| Centurion Of Missouri [20459] | $62 | 798% |
| Cherokee Nation Health Serv Contracted [320066] | $62 | 798% |
| Globalhealth Contracted [320145] | $62 | 798% |
| Novasys Contracted [320285] | $62 | 798% |
| Cross Timbers Hospice [20098] | $62 | 798% |
| Qual Choice Contracted [320325] | $62 | 798% |
| Aetna | $62 - $76 | 798% |
| Kindful Hospice Contracted [320434] | $62 | 798% |
| Kindful Hospice [20434] | $62 | 798% |
| Provider Partners Health Plans Contracted [320450] | $62 | 798% |
| Dept Of Veteran Affairs Contracted [320106] | $62 | 798% |
| Tricare | $62 | 798% |
| Elara Caring Aspire Hospice [20433] | $62 | 798% |
| Indian Health Service Contracted [320198] | $62 | 798% |
| Healthscope Contracted [320182] | $66 | 849% |
| Workers Comp [20426] | $68 - $72 | 875% |
| United Medical Resources Contracted [320454] | $71 - $81 | 914% |
| Medica Contracted [320239] | $76 | 978% |
| Mercy Benefit Admin Contracted [320251] | $76 - $81 | 978% |
| Federal Medical Center Contracted [320127] | $76 | 978% |
| Healthlink Contracted [320179] | $76 - $81 | 978% |
| American Healthcare Alliance Contracted [320020] | $76 | 978% |
| Usa Managed Care Org Contracted [320429] | $76 | 978% |
| First Health Contracted [320128] | $76 | 978% |
| Preferred Health Plan Contracted [320522] | $76 | 978% |
| Show-Me Health Administrators Contracted [320483] | $81 | 1042% |
| Aither Health Contracted [320449] | $81 | 1042% |
| Reflect Health Contracted [320492] | $81 | 1042% |
| 90 Degree Benefits Contracted [320436] | $81 | 1042% |
| Benefit Management Contracted [320052] | $81 | 1042% |
| Ebms Contracted [320493] | $81 | 1042% |
| Imagine 360 Contracted [320494] | $81 | 1042% |
| Edison Health Solutions Contracted [320502] | $81 | 1042% |
| Yuzu Health Contracted [320521] | $81 | 1042% |
| Point C Contracted [320238] | $81 | 1042% |
| Auxiant Contracted [320462] | $81 | 1042% |
| Private Health Care Systems Contracted [320320] | $81 | 1042% |
| Ppo Plus Contracted [320310] | $81 | 1042% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Mercy Hospital Columbus, the facility's cash price of $55.00 is lower than the state average of $72.00 and the median negotiated rate of $62.00. While many insurance plans pay significantly more than the cash price—ranging from $62 to $81 depending on the carrier—patients with high-deductible plans may find paying the cash rate directly more cost-effective, as the insurance allowed amount often exceeds the cash price. It is important to note that while the facility is a Critical Access Hospital in Kansas, commercial negotiated rates frequently include administrative overhead that can inflate the final cost compared to the direct cash price.
Patients should be aware of the potential for balance billing if they receive care from out-of-network providers, where the hospital bills the difference between the full chargemaster rate and the insurance allowed amount, though the No Surprises Act protects against this for emergency services at in-network facilities. To ensure the lowest possible cost, consumers should request a prompt-pay discount, which typically reduces the bill by 20% to 50% when paid upfront, bypassing the administrative costs associated with insurance claims processing. Additionally, if a summary bill is received, patients should demand a full itemized audit to verify that no unbundled codes or services not rendered have been charged, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.