Blood test, complete blood count (CBC)
Facility: Goodland Regional Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $68
- Cash Discount Price: $68
- vs. Medicare Baseline: 8.75x 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 875% of the Medicare baseline (a markup of 775%). 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% |
| Wppa | $65 - $68 | 837% |
| UnitedHealthcare | $68 | 875% |
Consumer Guidance & Cost Commentary
For a complete blood count (CBC) test at Goodland Regional Medical Center in Goodland, KS, the cash price is $68.00, which is significantly lower than the facility's gross charge of $76.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that insurance negotiated rates can sometimes exceed cash prices. For instance, WPPA plans have a negotiated range of $65 to $68, and UnitedHealthcare plans are set at $68, meaning a patient with a high deductible might save money by paying the cash price directly. It is always advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost.
When evaluating the cost against state standards, the cash price of $68.00 is notably higher than the Medicare benchmark of $7.77, reflecting the typical markup found in commercial healthcare pricing. However, the median negotiated rate for this service is also $68.00, indicating that in-network members are paying the same amount as cash payers for this specific test. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, where the provider charges the difference between their full rate and what your insurance allowed. To avoid surprise costs, ensure you have an itemized bill that lists every CPT code and service rendered, and do not sign away your rights to dispute out-of-network charges without reviewing the terms carefully.