Blood test, complete blood count (CBC)
Facility: Cheyenne County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $19
- Cash Discount Price: $20
- vs. Medicare Baseline: 2.45x 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 245% of the Medicare baseline (a markup of 145%). 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 | $2 - $20 | 26% |
| Blue Cross Blue Shield | $13 | 167% |
| First Health - All Plans | $14 | 180% |
| Choice Care - All Plans | $14 | 180% |
| Tricare | $14 | 180% |
| Aetna | $14 - $19 | 180% |
| Healthy Blue Mcr Adv | $14 | 180% |
| Firstguard - All Plans | $16 | 206% |
| Wppa - All Plans | $18 | 232% |
| Cpm - All Plans | $19 | 245% |
| Midlands Choice - All Plans | $19 | 245% |
| Health Partners - All Plans | $19 | 245% |
| Ppo Next - All Plans | $19 | 245% |
| Unicare - All Plans | $19 | 245% |
| Preferred Hc - All Plans | $19 | 245% |
| Integrated Hp - All Plans | $19 | 245% |
| Childrens Mercy - All Plans | $20 | 257% |
| Healthy Blue Mcaid - All Other Plans | $20 | 257% |
| Healthwave Mcaid - All Plans | $20 | 257% |
| Providers Care-All Plans | $30 | 386% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at Cheyenne County Hospital in St. Francis, KS, the facility's cash price is $20.00, which matches the cash median for this procedure in the region. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates for commercial payers range from $13.00 to $30.00 depending on the insurance plan. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; in this case, the cash price is equal to the lowest negotiated rate found ($13.00) but lower than the majority of payer contracts which cluster between $14.00 and $20.00. Patients with high-deductible plans may find the cash price more favorable if their insurance negotiated rate is higher than $20.00, as paying out-of-pocket avoids the full negotiated amount plus any potential deductibles.
When comparing this facility's pricing to federal benchmarks, the Medicare amount for this code is $7.77. The facility's cash price of $20.00 represents a significant markup over the Medicare rate, illustrating how commercial pricing can differ substantially from the government's cost-based standard. To minimize costs, patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may result in higher out-of-pocket expenses than the cash price. Additionally, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead associated with insurance