Blood test, complete blood count (CBC)
Facility: Bob Wilson Memorial Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $101
- Cash Discount Price: $50
- vs. Medicare Baseline: 13.00x 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 1300% of the Medicare baseline (a markup of 1200%). 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 |
|---|---|---|
| Centura Employee Plan | $10 | 129% |
| Blue Cross Blue Shield | $18 | 232% |
| Kansas Health | $40 | 515% |
| Medicare (plans) | $40 | 515% |
| UnitedHealthcare | $40 - $104 | 515% |
| Aetna | $40 - $99 | 515% |
| Humana | $40 | 515% |
| Multiplan | $112 - $115 | 1441% |
| Health Partners Of Kansas | $117 | 1506% |
| Wppa | $118 | 1519% |
Consumer Guidance & Cost Commentary
For the complete blood count (CBC) procedure at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's cash median price is $50.00, which is significantly lower than the state average of $124.00. While the hospital's negotiated rates with insurance payers range from $10 to $118, these amounts often exceed the cash price, making self-pay a potentially more cost-effective option for patients with high-deductible plans. Because the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should proactively contact the billing department to confirm "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead that typically inflates insurance negotiated rates.
It is important to distinguish between the facility's gross charge of $124.00 and the actual amounts paid by insurers, which vary widely depending on the plan. For instance, while Medicare allows $7.77 for this service, some commercial payers like Multiplan and Health Partners Of Kansas negotiate rates as high as $112 to $117. If you receive a bill that includes balance billing for out-of-network ancillary services, remember that the No Surprises Act generally protects you from these unexpected charges for emergency or non-emergency care at in-network facilities. Furthermore, since over 80% of hospital bills contain errors, always request a full itemized statement before paying; this allows you to verify that no services were unbundled or double-charged, ensuring you are only responsible for the accurate, final amount owed.