Blood test, complete blood count (CBC)
Facility: Republic County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $58
- Cash Discount Price: $47
- vs. Medicare Baseline: 7.46x 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 746% of the Medicare baseline (a markup of 646%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $54 | 695% |
| Meritain-All Plans | $57 | 734% |
| Aetna | $57 | 734% |
| UnitedHealthcare | $58 | 746% |
| First Health-All Plans | $60 | 772% |
| Cigna | $60 | 772% |
| Midlands Choice-All Plans | $60 | 772% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Republic County Hospital in Belleville, KS, the facility's cash price of $47.00 is lower than the state average of $58.00 and the median negotiated rate of $58.00. While the hospital's cash rate is also below the Medicare benchmark of $7.77 when adjusted for the facility's specific context, patients with high-deductible plans may find paying out-of-pocket for $47.00 more cost-effective than relying on insurance, which could result in a higher allowed amount due to administrative markups. It is important to note that commercial insurance carriers typically pay negotiated rates that often exceed cash prices because these rates include costs for claims processing and contract management, making direct payment a potentially smarter financial choice for many consumers.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like lab tests are billed separately. To avoid surprise costs, consumers should request a full itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. Additionally, asking the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling the test could further reduce the final cost, as facilities often offer significant reductions for upfront payments that bypass the slower insurance billing cycle.