Blood test, complete blood count (CBC)
Facility: Mitchell County Hospital Health Systems
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $122
- Cash Discount Price: $115
- vs. Medicare Baseline: 15.70x 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 1570% of the Medicare baseline (a markup of 1470%). 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 | $8 - $128 | 103% |
| Blue Cross Blue Shield | $13 | 167% |
| Triwest Well Mark All Plans | $109 | 1403% |
| Aetna | $115 | 1480% |
| First Health-All Plans | $115 | 1480% |
| Pref Hlth Care Sytms Comm - All Plans | $115 | 1480% |
| Multiplan Ppo - All Plans | $122 | 1570% |
| Phc Leased Ntwrk Access - All Plans | $122 | 1570% |
| Auxiant-All Plans | $122 | 1570% |
| Cigna | $127 | 1634% |
| Health Partners Ks-All Plans | $127 | 1634% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median price is $115.00, which aligns exactly with the median negotiated rate paid by insurance plans. This cash price is significantly lower than the facility's gross charge of $128.00 and represents a 15.7% increase over the Medicare benchmark of $7.77. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance contracts often result in higher allowable amounts than cash rates. For individuals with high-deductible plans, paying the $115.00 cash price upfront can be more cost-effective than relying on insurance, which may apply negotiated rates that exceed the cash amount before the deductible is met.
To minimize costs, patients should proactively contact the billing department to confirm if "self-pay" or "prompt-pay" discounts are available, as these programs can reduce the final bill by 20% to 50% for upfront payment. It is also important to request an itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. While the facility's pricing structure is transparent regarding its cash and negotiated rates, consumers should avoid assuming that being in-network guarantees the lowest price, as some commercial payers may have higher allowed amounts than the cash price.