Blood test, complete blood count (CBC)
Facility: Ellsworth County Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $15
- Cash Discount Price: $17
- vs. Medicare Baseline: 1.93x 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 |
|---|---|---|
| Va Ccn-All Plans | $8 | 103% |
| Healthy Blue Mcr Adv | $8 | 103% |
| Humana | $8 - $16 | 103% |
| Triwest -All Plans | $8 | 103% |
| UnitedHealthcare | $11 - $16 | 142% |
| Blue Cross Blue Shield | $13 | 167% |
| First Health - All Plans | $15 | 193% |
| Aetna | $15 | 193% |
| Healthy Blue Mcaid- All Other Plans | $16 | 206% |
| Coventry Mcaid-All Plans | $16 | 206% |
| Medicaid / KanCare | $16 | 206% |
| Cigna | $16 | 206% |
| Providers Care-Wppa-All Plans | $25 | 322% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Ellsworth County Medical Center in Ellsworth, Kansas, the cash median price is $17.00, which matches the facility's gross charge. This rate is significantly lower than the state average of $25.00 and the county average of $25.00, making it a competitive option for self-pay patients. While the facility's negotiated rates with major payers like Humana and UnitedHealthcare range from $8 to $16, these amounts often exceed the cash price. For patients with high-deductible plans or those without insurance, paying the cash median of $17.00 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rates, provided the patient's deductible has not been met.
To ensure you receive the most accurate pricing, it is essential to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these can further reduce the final bill. If you are using insurance, be aware that while the facility is in-network for most major carriers, the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, though you should still request an itemized bill to verify all charges. Since over 80% of hospital bills contain errors, do not accept a summary bill as final; instead, request a detailed, line-by-line statement to identify any unbundled codes or services not rendered. Finally, compare the facility's Medicare benchmark of $7.77 against your commercial rates to understand the markup, noting that fair pricing is typically defined as 120% to 150% of the Medicare amount.