Blood test, complete blood count (CBC)
Facility: Great Plains Of Sabetha
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $41
- Cash Discount Price: $43
- vs. Medicare Baseline: 5.28x 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 528% of the Medicare baseline (a markup of 428%). 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 |
|---|---|---|
| Celtic Mcr Adv | $21 - $23 | 270% |
| Aetna | $22 - $44 | 283% |
| Celtic Comm Exchange-All Other Plans | $27 - $29 | 347% |
| Great West Healthcare-All Plans | $35 - $37 | 450% |
| UnitedHealthcare | $38 - $44 | 489% |
| Century/Wppa/Providers-All Plans | $39 - $42 | 502% |
| Humana | $39 - $42 | 502% |
| Federated Mutual Ins-All Plans | $39 - $42 | 502% |
| Multiplan-Phcs-All Plans | $39 - $42 | 502% |
| Cigna | $39 - $42 | 502% |
| Blue Cross Blue Shield | $41 - $44 | 528% |
| Medicaid / KanCare | $41 - $44 | 528% |
Consumer Guidance & Cost Commentary
For this blood test service at Great Plains Of Sabetha, the cash price of $43.00 is identical to the facility's median negotiated rate of $41.00 and the cash median, indicating that paying out-of-pocket here offers the most direct pricing available. While the facility's negotiated rates for this procedure range from $21 to $44 depending on the insurance carrier, the cash price remains the baseline against which insurance savings should be measured. It is important to note that for patients with high-deductible plans, paying the cash price of $43.00 upfront may be more cost-effective than using insurance, as the insurer's negotiated allowed amount could exceed the cash rate, potentially leading to higher out-of-pocket costs after deductibles are met.
To ensure you are receiving the best possible rate, you should verify if the facility offers a "prompt-pay" discount for upfront payment, which can reduce the bill by 20% to 50% by bypassing administrative claim processing fees. Additionally, if you have an out-of-network provider or encounter unexpected charges, the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities. If you receive a summary bill, request a full itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute sent to the billing supervisor.