Blood test, complete blood count (CBC)
Facility: William Newton Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $9
- Cash Discount Price: $35
- vs. Medicare Baseline: 1.16x 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.
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 |
|---|---|---|
| Triwest- All Plans | $2 - $23 | 26% |
| Ambetter / Centene | $2 - $65 | 26% |
| UnitedHealthcare | $2 - $58 | 26% |
| Blue Cross Blue Shield | $2 - $23 | 26% |
| Providrs Care - All Other Plans | $4 - $45 | 51% |
| Providrs Care Nexus | $4 - $40 | 51% |
Consumer Guidance & Cost Commentary
For a complete blood count (CBC) at William Newton Hospital in Winfield, KS, the cash price is $35.00, which matches the facility's cash median. This rate is significantly lower than the state average for this service, as indicated by a comparison factor of 1.2 against Medicare benchmarks. While commercial insurance plans like Triwest, Ambetter, and UnitedHealthcare negotiate rates ranging from $2 to $65 depending on the specific plan, these negotiated amounts often exceed the cash price. For patients with high-deductible plans, paying the $35.00 cash rate directly may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not yet been met.
To ensure you are not overcharged, it is important to understand that hospitals often offer prompt-pay discounts for self-pay patients, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill that obscures individual charges. If you receive a balance bill for services rendered at this Critical Access Hospital, remember that the No Surprises Act generally protects you from being billed for out-of-network emergency care or non-emergency services at in-network facilities. Always verify your specific plan details and ask the billing department about self-pay or prompt-pay options before scheduling your appointment to avoid unexpected costs.