Blood test, complete blood count (CBC)
Facility: Kiowa County Memorial Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $92
- Cash Discount Price: $88
- vs. Medicare Baseline: 11.84x 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 1184% of the Medicare baseline (a markup of 1084%). 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 - $92 | 167% |
| UnitedHealthcare | $82 - $103 | 1055% |
| Health Partners Of Ks-All Plans | $91 | 1171% |
| Celtic Comml Exchange-All Other Plans | $92 | 1184% |
| Medica Prime Mcare Cost-All Plans | $92 | 1184% |
| Humana | $92 | 1184% |
| Aetna | $92 | 1184% |
| Medicaid / KanCare | $103 | 1326% |
| Providrs Care/Wppa-All Plans | $154 | 1982% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Kiowa County Memorial Hospital in Greensburg, Kansas, the facility's negotiated rates range from $13 to $154 depending on your specific insurance plan, with a median negotiated amount of $92. This is notably higher than the facility's cash price of $88, which may offer significant savings if you have a high-deductible plan or no insurance. While the hospital is a Critical Access Hospital owned by the local government, patients should verify their specific plan's allowed amount before scheduling, as some commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates that can exceed the cash price. It is important to ask the billing department about "self-pay" or "prompt-pay" discounts upfront, as paying in full within a short window can sometimes reduce the final cost by 20% to 50% before insurance claims are even processed.
The facility's Medicare benchmark of $7.77 serves as the objective baseline for pricing, revealing that the commercial negotiated rates are substantially higher than the federal government's cost-based reimbursement. Although the data does not provide explicit county or state average comparisons for this specific CPT code, the wide variance in payer rates—from $13 for some Blue Cross Blue Shield plans up to $154 for Providrs Care/Wppa-All Plans—highlights the importance of checking your individual plan details. Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but unexpected charges can still occur if ancillary services like lab tests are billed out-of-network. To ensure you are not overcharged, request a detailed, itemized bill that lists every CPT code