Blood test, complete blood count (CBC)
Facility: Greenwood County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $88
- Cash Discount Price: $83
- vs. Medicare Baseline: 11.33x 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 1133% of the Medicare baseline (a markup of 1033%). 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 |
|---|---|---|
| UnitedHealthcare | $8 - $87 | 103% |
| Blue Cross Blue Shield | $13 | 167% |
| Triwest - All Plans | $37 | 476% |
| Choicecare Mcr Adv - All Plans | $44 | 566% |
| Tricare | $44 | 566% |
| Integrated Health Plan - All Plans | $78 | 1004% |
| Beech Street - All Plans | $88 | 1133% |
| First Health - All Other Plans | $88 | 1133% |
| First Health Ccn Network | $88 | 1133% |
| Preferred Hs (Coventry) - All Plans | $94 | 1210% |
| Principal Health Care Inc - All Plans | $99 | 1274% |
| Medicaid / KanCare | $104 | 1338% |
| Amerigroup Mcaid-All Plans | $104 | 1338% |
| Providrs Care/Wppa - All Plans | $156 | 2008% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Greenwood County Hospital in Eureka, Kansas, the cash price is $83.00, which is lower than the facility's negotiated rates of $88.00 paid by most insurance plans. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than paying cash directly. If you have a high-deductible plan, paying the $83.00 cash price upfront may be more economical than your insurance covering the $88.00 negotiated rate, especially if your deductible has not yet been met. To secure the best possible rate, we recommend asking the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these programs can further reduce the final amount owed.
The Medicare benchmark for this service is $7.77, which serves as a baseline for evaluating fair pricing; commercial rates are often significantly higher due to administrative costs and contract structures. Although the data does not provide specific state or county average comparisons for this exact code, the facility's cash rate of $83.00 is notably higher than the Medicare amount, reflecting the typical markup found in commercial billing. If you receive a bill that exceeds these amounts, it is advisable to request an itemized billing audit to identify any errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain discrepancies. Additionally, if you are concerned about balance billing from out-of-network providers, remember that the No Surprises Act protects you from being billed for the difference between the provider's full charge and your insurance allowed amount for emergency care and non-emergency