Blood test, complete blood count (CBC)
Facility: Scott County Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $68
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| UnitedHealthcare | $7 - $71 | 90% |
| Blue Cross Blue Shield | $13 | 167% |
| Humana | $32 | 412% |
| Wppa | $45 - $1,200 | 579% |
| Aetna | $68 | 875% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $7 to $1200 depending on the insurance plan, with a median negotiated amount of $68.00. The Medicare benchmark for this service is $7.77, meaning commercial rates are significantly higher than the federal baseline. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash-pay options are not listed in this report. However, if you have a high-deductible plan where your insurance allowed amount exceeds the cash price, paying out-of-pocket might be more cost-effective. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if settled upfront.
The data indicates that while some payers like UnitedHealthcare and Blue Cross Blue Shield have very narrow rate bands, others like WPPA show a wide variance between their lowest and highest plan rates. Because commercial negotiated rates often include administrative overhead and contract dynamics that inflate the baseline price, comparing these figures directly to the Medicare rate provides a clearer picture of the facility's markup. If you receive a bill that appears to include balance billing for out-of-network services at this in-network facility, you may be entitled to protections under the No Surprises Act, which bans surprise bills for emergency care and non-emergency services at in-network hospitals. To ensure you are not overcharged, request a full itemized bill showing specific CPT codes rather than accepting a summary invoice, and dispute any errors in writing to avoid unexpected debt.