Blood test, complete blood count (CBC)
Facility: F W Huston Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $62
- Cash Discount Price: $64
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $13 | 167% |
| Aetna | $60 | 772% |
| Humana | $63 | 811% |
| Cigna | $68 | 875% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at F W Huston Medical Center in Winchester, KS, the facility's cash median rate is $64.00, while the median negotiated rate paid by insurance payers is $62.00. Although the cash price is slightly higher than the negotiated average, patients with high-deductible plans may find paying $64.00 upfront more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash price. It is important to note that this facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and the specific Medicare benchmark for this service is $7.77, which serves as the objective baseline for evaluating pricing markup rather than the facility's gross charge of $80.00.
To ensure you are not overcharged, always request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a surprise bill, remember that the No Surprises Act generally protects you from balance billing for out-of-network services at in-network facilities, so you should dispute any unexpected charges in writing rather than paying immediately out of fear. Additionally, since hospitals often offer prompt-pay discounts to patients who settle their balance upfront, you should explicitly ask the billing department about self-pay or prompt-pay rates before scheduling your visit to potentially lower your out-of-pocket costs.