Blood test, complete blood count (CBC)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $35
- Cash Discount Price: $82
- vs. Medicare Baseline: 4.50x 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 450% of the Medicare baseline (a markup of 350%). 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 |
|---|---|---|
| Medicaid / KanCare | $7 | 90% |
| Blue Cross Blue Shield | $15 - $35 | 193% |
| Tricare | $34 | 438% |
| Aetna | $35 | 450% |
| Medadv_Allwell | $35 | 450% |
| Medicare (plans) | $35 | 450% |
| Humana | $35 | 450% |
| Medadv_Uhc | $35 | 450% |
| Va_Ccn | $35 | 450% |
| Ambetter / Centene | $37 | 476% |
| Wppa_Providrscare | $91 | 1171% |
| United | $91 | 1171% |
| Cigna | $104 | 1338% |
| Coventry | $104 | 1338% |
| Hpk | $104 | 1338% |
Consumer Guidance & Cost Commentary
For this complete blood count (CBC) test at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash price of $82.00 is significantly lower than the typical negotiated rates charged by major insurers like Blue Cross Blue Shield ($35–$35), United ($91), and Cigna ($104). While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans or those without insurance may find the cash price more affordable than the amount their insurance would allow to pay, which often exceeds the cash rate. It is important to note that commercial insurance contracts frequently include administrative overheads that inflate the baseline price, meaning the negotiated rate does not always represent the lowest possible cost for the service.
To minimize out-of-pocket expenses, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, if you are billed for this service while receiving care from an out-of-network provider, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services at in-network facilities. If you do receive a surprise bill, do not pay it immediately; instead, request a formal itemized audit to identify any unbundled codes or services not rendered, and dispute the balance with your insurer to ensure you are not being charged for the difference between the provider's full chargemaster rate and your allowed amount.