Blood test, complete blood count (CBC)
Facility: Hodgeman County Health Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $79
- Cash Discount Price: $90
- vs. Medicare Baseline: 10.17x 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 1017% of the Medicare baseline (a markup of 917%). 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 | $13 | 167% |
| UnitedHealthcare | $72 - $106 | 927% |
| Humana | $72 | 927% |
| Triwest - All Plans | $72 | 927% |
| Medicaid / KanCare | $72 - $112 | 927% |
| Aetna | $90 | 1158% |
| First Health - All Plans | $101 | 1300% |
| Health Partners - All Plans | $106 | 1364% |
| Wppa (Provdrscare) - All Plans | $106 | 1364% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash median price is $90.00, which is notably lower than the state average of $112.00. While many commercial payers negotiate rates that exceed this cash price—such as UnitedHealthcare and Medicaid/KanCare plans with negotiated amounts ranging from $72 to $112—patients with high-deductible plans may find paying the cash rate directly more cost-effective. This is because the cash price avoids the administrative overhead and markup inherent in insurance billing cycles. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing the standard insurance claims processing fees.
The facility's negotiated rates vary significantly by insurer, with the lowest allowed amount being $13.00 for Blue Cross Blue Shield and the highest at $112.00 for Medicaid/KanCare, reflecting the complex dynamics of commercial contracts versus federal benchmarks. For context, the Medicare benchmark for this service is $7.77, indicating that even the lowest commercial negotiated rates are substantially higher than the federal baseline, while the facility's cash rate remains competitive. It is important to note that while the No Surprises Act protects patients from unexpected balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and deductible status before relying on insurance coverage, as some plans may still result in higher out-of-pocket costs if the deductible has not been met.