Blood test, complete blood count (CBC)
Facility: Amberwell Atchison Association
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $24
- Cash Discount Price: $47
- vs. Medicare Baseline: 3.09x 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 309% of the Medicare baseline (a markup of 209%). 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% |
| Superior Select Mcr Adv - All Plans | $16 | 206% |
| Humana | $16 - $21 | 206% |
| Triwest - All Plans | $16 | 206% |
| Va Ccn - All Plans | $16 | 206% |
| UnitedHealthcare | $16 - $84 | 206% |
| Ambetter / Centene | $24 | 309% |
| Aetna | $26 | 335% |
| Cigna | $26 | 335% |
| Centrus Health Direct - All Plans | $35 | 450% |
| Oscar - All Plans | $35 | 450% |
| Multiplan - All Plans | $37 | 476% |
| Wppa Providrs Care - All Plans | $42 | 541% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) test at Amberwell Atchison Association, the cash price is $47.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the Medicare benchmark of $7.77, indicating a markup of 3.1 times the federal rate. While the facility is a Critical Access Hospital in Atchison, KS, the data provided does not include specific state or county average figures for comparison. However, patients should be aware that commercial insurance plans often negotiate rates higher than cash prices; for instance, UnitedHealthcare's negotiated range spans from $16 to $84, and Humana's range is $16 to $21. If you have a high-deductible plan, paying the $47.00 cash price upfront may be more cost-effective than relying on insurance, which could result in a higher allowed amount after deductibles are met.
To minimize costs, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window. It is crucial to request this discount before scheduling your visit and to sign a waiver preventing automatic claims submission to ensure the cash rate applies. Additionally, if you are using insurance, be cautious of balance billing scenarios where out-of-network ancillary services might trigger unexpected charges, though the No Surprises Act protects you from such billing for emergency care and non-emergency services at in-network facilities. Always request a detailed, itemized bill before paying to verify that all charges are accurate and that no unbundled codes or services not rendered have been included