Blood test, complete blood count (CBC)
Facility: Kearny County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $48
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 6.18x 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 618% of the Medicare baseline (a markup of 518%). 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 | $48 | 618% |
| Community Care Health Plan Of | $48 - $12,010 | 618% |
| Meritain Health | $48 | 618% |
| Kansas Solutions | $48 | 618% |
| American Health Plans | $48 | 618% |
| Blue Cross Blue Shield | $48 | 618% |
| Humana | $48 | 618% |
| Cigna | $48 | 618% |
| UnitedHealthcare | $48 | 618% |
| Wps Gha - Mac J5 Part A | $48 - $96 | 618% |
| Luminare Health | $48 | 618% |
| Benefit Plan Administrators | $325 | 4183% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Kearny County Hospital in Lakin, KS, the facility's negotiated rates range from $48 to $12,010 across 12 different payers, with a median negotiated amount of $48.00. This facility is a Critical Access Hospital owned by the local government, and its pricing structure is significantly lower than the national average for this service. While the facility's gross charge is $72.00, commercial payers generally pay a median of $25.00, which is 6.2% below the Medicare benchmark of $7.77. It is important to note that while cash payments are sometimes cheaper for patients with high-deductible plans when insurance negotiated rates exceed the cash price, this specific data set does not provide a cash median, so patients should directly inquire about self-pay or prompt-pay discounts before scheduling.
Patients should be aware that commercial insurance contracts often create a ceiling on what insurers will pay, which can sometimes result in higher allowed amounts than the facility's cash rate due to administrative costs and contract dynamics. For instance, while the median negotiated rate here is $48.00, the gross charge is $72.00, illustrating the difference between what the hospital charges and what insurers agree to pay. To ensure you are not overcharged, it is recommended to request an itemized billing audit if you receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you encounter a balance bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act