Blood test, complete blood count (CBC)
Facility: Stafford County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $84
- Cash Discount Price: $88
- vs. Medicare Baseline: 10.81x 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 1081% of the Medicare baseline (a markup of 981%). 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 |
|---|---|---|
| Va Ccn-All Plans | $7 | 90% |
| UnitedHealthcare | $7 | 90% |
| Health Partners-All Plans | $84 | 1081% |
| Humana | $88 | 1133% |
| Medica Mcr- All Plans | $88 | 1133% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at Stafford County Hospital, the cash price of $88.00 is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare ($88.00) and Health Partners ($84.00). While the facility's cash rate matches the gross charge, it remains higher than the state of Kansas average for this service, which is reflected in the median negotiated rate of $84.00 across the five participating plans. Patients with high-deductible plans may find the cash price more affordable than their insurance allowed amount, as commercial contracts often include administrative overhead that inflates the baseline price by 20% to 40% above the true cost of care.
To minimize out-of-pocket costs, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, since Medicare benchmarks this service at $7.77, the commercial rates represent a substantial markup; however, comparing the cash price to the Medicare rate is the most accurate way to understand the facility's pricing structure. We advise requesting a full itemized bill before payment to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.