Blood test, complete blood count (CBC)
Facility: Lincoln County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $13
- Cash Discount Price: $57
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $13 | 167% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at Lincoln County Hospital in Lincoln, KS, the cash price of $57.00 is significantly lower than the facility's negotiated rate of $13.00, which is the amount Blue Cross Blue Shield pays. This facility is a Critical Access Hospital with government-local ownership, and while the cash price is competitive, it is important to note that commercial insurance rates often exceed cash prices due to administrative overhead. If you have a high-deductible plan, paying the cash price upfront might be more cost-effective than relying on insurance, especially since the negotiated rate of $13.00 does not reflect the full chargemaster gross of $63.00. Always verify if your specific plan has a deductible that would make the insurance payment higher than the cash amount.
To ensure you are receiving the best possible price, we recommend requesting an itemized bill before finalizing payment to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you pay in full within 30 days. When comparing this facility's pricing to broader benchmarks, the Medicare amount for this procedure is $7.77, and the commercial negotiated rate is 1.7 times the Medicare rate. Since fair pricing is typically defined as 120% to 150% of Medicare, the current negotiated rate suggests a markup that may be higher than the standard range, making the cash option an attractive alternative for self-pay patients.