CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $9
Cash Discount Price: $114
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at UMass Memorial Healthalliance Hospitals is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.16x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)

Cash / Self-Pay: $114 (1467%)

Insurance Median: $9 (116%)

Cash: $114 (1467% of Medicare)

Ins. Median: $9 (116% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Institution [10406]	$7 - $60	90%
Masshealth [20302]	$7	90%
Medicaid / KanCare	$7 - $9	90%
Aetna	$8 - $75	103%
Blue Cross Blue Shield	$8 - $25	103%
Champva [11001]	$8	103%
Cigna	$8 - $30	103%
Commonwealth Care Mcr [10115]	$8	103%
Fallon Mcr Supp [20202]	$8	103%
Grants [20507]	$8 - $114	103%
Harvard Pilgrim Mcr [10106]	$8	103%
Medicare (plans)	$8	103%
Mgb Mcr [10124]	$8	103%
Senior Whole Health [10110]	$8	103%
Tufts Dual [10111]	$8	103%
Tufts Mcr [10112]	$8	103%
Tufts Us Family [11203]	$8	103%
UnitedHealthcare	$8 - $114	103%
Correctional Care [11003]	$11 - $12	142%
Workers Compensation [20501]	$11	142%
Tufts Connectorcare [10507]	$13	167%
Tufts [11201]	$17	219%
Harvard Pilgrim [10701]	$18 - $22	232%
Wellpoint [11112]	$20	257%
Fallon Connectorcare [10503]	$46	592%
Hne [11108]	$64	824%
First Health Network [11120]	$86	1107%
Multiplan [11109]	$86	1107%
Connecticare [11105]	$114	1467%
Fallon Carelon Hlth [28]	$114	1467%
Fallon Mcaid Carelon Hlth [29]	$114	1467%
Hsno/Free Care [10801]	$294	3784%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $114.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Healthalliance Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85025.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.