Blood test, complete blood count (CBC)
Facility: Wamego Health Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $7
- Cash Discount Price: $66
- vs. Medicare Baseline: 0.90x 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 | $7 | 90% |
| Aetna | $7 | 90% |
| Medicaid / KanCare | $7 | 90% |
| Providrs Care | $8 | 103% |
| Blue Cross Blue Shield | $141 - $149 | 1815% |
Consumer Guidance & Cost Commentary
For the CPT code 85025, a complete blood count (CBC) at Wamego Health Center in Wamego, KS, the cash median price is $66.00. This cash rate is significantly lower than the facility's negotiated rates with major payers such as UnitedHealthcare, Aetna, and Medicaid/KanCare, which range from $7.00 to $149.00 depending on the specific plan. While commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, the cash price here remains the most affordable option for self-pay patients. It is important to note that for patients with high-deductible plans, paying the cash price upfront can sometimes be cheaper than the insurance negotiated rate if the insurer's allowed amount exceeds the cash price, though this specific code shows the cash rate is already the lowest available.
The facility's pricing structure aligns with the principle of itemized billing audits, as patients should request a detailed, line-by-line statement rather than accepting a summary bill that obscures individual charges. Although the data does not provide a specific county or state average for this procedure to make a direct comparison, the facility's cash rate of $66.00 is notably lower than its own negotiated rates, illustrating how commercial contracts can result in higher costs for insured members. To ensure you are not overcharged, always verify the exact CPT code and unit costs on your invoice, and consider asking for a prompt-pay discount if you choose to pay in full before or shortly after the service, which can further reduce the total amount owed.