Blood test, complete blood count (CBC)
Facility: Norton County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $19
- Cash Discount Price: $33
- vs. Medicare Baseline: 2.45x 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 245% of the Medicare baseline (a markup of 145%). 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 | $19 | 245% |
Consumer Guidance & Cost Commentary
For this blood test at Norton County Hospital, the cash price of $33.00 is significantly lower than the negotiated rate of $19.00 paid by Blue Cross Blue Shield. While the facility is a Critical Access Hospital in Norton, KS, the data does not include specific county or state average comparisons for this service. However, it is important to note that for patients with high-deductible plans, paying the cash price of $33.00 upfront can sometimes be more cost-effective than relying on insurance, especially if the negotiated rate exceeds the cash price. Patients should always ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The Medicare benchmark for this procedure is $7.77, which serves as a baseline for evaluating the facility's pricing structure. The gross charge of $47.00 represents the full list price before any discounts or insurance negotiations. If a patient receives care from an out-of-network provider, they could face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects patients from such surprise bills for emergency services and non-emergency services at in-network facilities. To avoid unexpected costs, consumers should request a detailed, itemized bill to verify that all charges are accurate and that no services were unbundled or double-billed, as over 80% of hospital bills contain errors.