Blood test, complete blood count (CBC)
Facility: Clay County Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $67
- Cash Discount Price: $71
- vs. Medicare Baseline: 8.62x 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 862% of the Medicare baseline (a markup of 762%). 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 |
|---|---|---|
| Aetna | $66 | 849% |
| Wppa/Providrs Care- All Plans | $66 | 849% |
| Health Partners - All Plans | $67 | 862% |
| Multiplan- All Plans | $67 | 862% |
| UnitedHealthcare | $67 | 862% |
Consumer Guidance & Cost Commentary
At Clay County Medical Center in Clay Center, KS, the negotiated rate for a complete blood count (CBC) is $67, which aligns closely with the state average of $67 and is slightly higher than the county average of $66. While the facility's cash price is listed at $71, patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated rate of $67 could result in a higher out-of-pocket cost if the patient's deductible has not yet been met. It is important to note that commercial rates often include administrative overhead for claims processing, which can inflate the baseline price compared to the true cost of care.
To ensure you are receiving the most accurate pricing, always request an itemized bill that breaks down the specific CPT code and unit costs rather than accepting a broad summary invoice. If you receive a bill for $71 or more, verify that no unbundled charges or services not rendered have been included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, since this facility is a Critical Access Hospital with government ownership, you should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes bypass the administrative costs associated with insurance billing cycles.