Blood test, complete blood count (CBC)
Facility: Graham County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $14
- Cash Discount Price: $19
- vs. Medicare Baseline: 1.80x 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.
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 | $1 - $19 | 13% |
| Medicaid / KanCare | $11 | 142% |
| Blue Cross Blue Shield | $13 | 167% |
| Medicare (plans) | $13 - $15 | 167% |
| Celtic Commercial-All Other Plans | $14 - $16 | 180% |
| Wppa (Providers Care)-All Plans | $16 - $19 | 206% |
Consumer Guidance & Cost Commentary
For this blood test (CPT 85025) at Graham County Hospital in Hill City, KS, the cash price is $19.00, which matches the facility's median negotiated rate of $16.00 and the state average of $19.00. While Medicare reimburses $7.77 for this service, commercial payers negotiate rates ranging from $14.00 to $19.00 depending on the plan, with Medicaid/KanCare and Blue Cross Blue Shield paying the lowest amounts in this group. Because the cash price aligns with the state average and exceeds the Medicare benchmark, patients with high-deductible plans may find paying out-of-pocket directly to the hospital is the most cost-effective option, provided they secure a prompt-pay discount before the claim is submitted to their insurer.
To maximize savings, patients should explicitly request a self-pay or prompt-pay discount at the time of registration, as hospitals often offer significant reductions for upfront payments that bypass insurance administrative fees. It is important to verify your deductible status before scheduling, as using an in-network plan without meeting your deductible could result in paying the full negotiated rate of $16.00 or higher rather than the discounted cash price. Since the facility is a Critical Access Hospital with government-local ownership, you should also ask for an itemized bill to ensure no unbundled charges or services not rendered are included, as these can inflate the total cost significantly beyond the listed CPT code amount.