Blood test, complete blood count (CBC)
Facility: Wilson Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $13
- Cash Discount Price: $22
- vs. Medicare Baseline: 1.67x 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 |
|---|---|---|
| Tricare | $5 - $25 | 64% |
| UnitedHealthcare | $5 - $45 | 64% |
| Humana | $5 - $25 | 64% |
| Ambetter / Centene | $5 - $48 | 64% |
| Aetna | $5 - $48 | 64% |
| Cigna | $8 - $38 | 103% |
| Health Partners-All Plans | $9 - $44 | 116% |
| Mulitplan-All Plans | $9 - $44 | 116% |
| Blue Cross Blue Shield | $10 - $48 | 129% |
Consumer Guidance & Cost Commentary
For the CPT code 85025, a complete blood count (CBC) at Wilson Medical Center in Neodesha, KS, the facility's cash median rate is $22.00, while the median negotiated rate for commercial payers is $13.00. This service is provided at a Critical Access Hospital, a facility type often subject to specific federal payment rules that can influence pricing structures. When comparing these rates to the broader market, the facility's cash price of $22.00 is significantly higher than the Medicare benchmark of $7.77, which serves as the objective baseline for evaluating cost. While commercial negotiated rates average between 200% and 300% of Medicare, the facility's negotiated rate of $13.00 falls below the typical commercial markup range, suggesting a favorable contract for in-network members. However, patients with high-deductible plans should note that paying cash at $22.00 may be more cost-effective than using insurance if the insurer's allowed amount exceeds the cash price, as the administrative overhead and contract dynamics often inflate the final bill for insured patients.
Patients should be aware that the facility offers a median negotiated rate of $13.00, but this does not guarantee the lowest possible price for every individual. To potentially reduce costs, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount for upfront payment. These discounts bypass the costly insurance claims processing cycle, saving the facility administrative labor and providing immediate liquidity. Additionally, because the facility is a government-owned Critical Access