Blood test, complete blood count (CBC)
Facility: Jewell County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $88
- Cash Discount Price: $69
- vs. Medicare Baseline: 11.33x 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 1133% of the Medicare baseline (a markup of 1033%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $78 | 1004% |
| Meritain - All Plans | $83 | 1068% |
| Aetna | $83 | 1068% |
| UnitedHealthcare | $88 | 1133% |
| Cigna | $88 | 1133% |
| First Health - All Plans | $88 | 1133% |
| Midlands Choice - All Plans | $88 | 1133% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Jewell County Hospital in Mankato, KS, the facility's cash price of $69.00 is lower than the median negotiated rate of $88.00 paid by insurance carriers. This difference highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. While the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan details before scheduling, as paying cash or utilizing prompt-pay discounts may reduce the final amount owed. It is important to note that while the facility's cash rate is competitive, the negotiated rates across seven payers range from $78 to $88, meaning some insurance plans may cover less than the cash price.
When reviewing your bill, be aware that commercial rates are frequently higher than the Medicare benchmark of $7.77 for this service, which serves as a scientifically validated baseline for true healthcare costs. Although the data shows a 11.3% variance compared to Medicare, patients should avoid comparing discounts against the hospital's gross charge of $92.00, as this inflates the perceived savings. Instead, focus on the itemized statement to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. If you receive a balance bill from an out-of-network provider, even at an in-network facility, you may have rights under the No Surprises Act to dispute the charge, and you should always request a full itemized audit before signing any consent waivers that could waive these protections.