Blood test, complete blood count (CBC)
Facility: Stanton County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $94
- Cash Discount Price: $62
- vs. Medicare Baseline: 12.10x 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 1210% of the Medicare baseline (a markup of 1110%). 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 - $230 | 167% |
| Healthy Blue Mcr Adv - All Other Plans | $93 - $238 | 1197% |
| Healthy Blue Mcaid | $94 - $207 | 1210% |
Consumer Guidance & Cost Commentary
For a complete blood count (CBC) at Stanton County Hospital in Johnson, KS, the cash price of $62.00 is significantly lower than the facility's negotiated rates with major payers, which range from $93 to $238. This price difference highlights a common billing dynamic where commercial insurance contracts often result in higher costs for patients than paying out-of-pocket, particularly if the patient has a high deductible. While the facility is a Critical Access Hospital with government local ownership, patients should verify their specific plan details, as paying cash upfront can sometimes be the most cost-effective option if the insurance negotiated rate exceeds the cash price.
To ensure you are not overcharged, it is advisable to request a prompt-pay discount before scheduling your visit, as hospitals often offer reductions for upfront payments that bypass the administrative costs of insurance billing. Additionally, if you receive a bill from an out-of-network provider or for services not covered by your plan, you may be subject to balance billing, which is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. Always demand a full itemized bill rather than accepting a summary invoice, and if you encounter unexpected charges, dispute them in writing to avoid paying for services that were never rendered or codes that were incorrectly unbundled.