Blood test, complete blood count (CBC)
Facility: Lindsborg Community Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $19
- Cash Discount Price: $26
- 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 |
|---|---|---|
| Coventry Mcr Adv | $9 - $26 | 116% |
| Tricare | $9 - $25 | 116% |
| Blue Cross Blue Shield | $13 | 167% |
| Cigna | $17 - $46 | 219% |
| Coventry Comm-All Other Plans | $18 - $49 | 232% |
| UnitedHealthcare | $18 - $49 | 232% |
| Health Partners -All Plans | $19 - $51 | 245% |
| Multiplan-All Plans | $19 - $50 | 245% |
| Coventry Wc | $19 - $51 | 245% |
| Wppa-All Plans | $19 - $51 | 245% |
| Phcs Preferred-All Plans | $19 - $50 | 245% |
| Century Health-All Plans | $19 - $51 | 245% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Lindsborg Community Hospital, the cash price is $26.00, which is lower than the facility's negotiated rates for most commercial payers. While the hospital's median negotiated rate is $19.00, this amount is still higher than the cash price, meaning patients with high-deductible plans might save money by paying cash directly rather than using insurance. It is important to note that commercial insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40%, so the negotiated rate does not always represent the lowest possible cost. Additionally, the facility's cash rate of $26.00 is higher than the Medicare benchmark of $7.77, indicating a significant markup relative to the federal government's fixed reimbursement rate.
Patients should verify their specific plan details before scheduling, as assuming that being in-network guarantees the best price can be misleading. Some in-network hospitals charge significantly more than others, and patients must check their deductible status to avoid paying the full negotiated rate if they have not yet met their out-of-pocket threshold. To potentially reduce costs further, individuals should 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 payments. Finally, if a balance bill arises from an out-of-network service, patients should not pay immediately but instead request a formal itemized audit to identify errors or dispute the charge under federal protections.