CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Cambridge Health Alliance

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $46
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 5.92x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Cambridge Health Alliance is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 5.92x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $46 (592%)
Insurance Median: $46 (592%)
Cash: $46 (592% of Medicare)
Ins. Median: $46 (592% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 592% of the Medicare baseline (a markup of 492%). 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.

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
Boston Medical Center - Wellsense [50003] $7 90%
Fallon [50006] $7 90%
Mass Bh Partnership [70098] $7 90%
Mass General Brigham [50021] $7 - $29 90%
Mass Health [70001] $7 90%
Medicaid / KanCare $7 90%
Other Tufts Health Public Plan [75002] $7 - $13 90%
Tufts Together W Cha [75001] $7 90%
UnitedHealthcare $7 - $25 90%
Medicare (plans) $8 - $46 103%
Aarp [40001] $11 142%
Oxford Health [40004] $11 142%
United Medical Resource [40005] $11 142%
Wc [90001] $11 142%
Blue Cross Blue Shield $15 - $46 193%
Wellpoint [50012] $16 206%
Aetna $21 - $46 270%
Cigna $22 - $54 283%
Tufts Health Plan [30001] $22 - $26 283%
Health Plans Inc [20002] $25 322%
Hphc [20001] $25 322%
Multiplan [50010] $31 399%
Altus Dental [99011] $46 592%
Beacon Health Strategies [50002] $46 592%
Cbhc Uninsured Crisis Alt Payer [70097] $46 592%
Cbhc Uninsured Crisis [70096] $46 592%
Celticare [50004] $46 592%
Commonwealth Care Alliance Dental [99004] $46 592%
Coverage Discovery [90004] $46 592%
Delta Dental Of Ma [99007] $46 592%
Dominion National Dental [99012] $46 592%
Dph Tb Payor [85004] $46 592%
Esp Dental [99003] $46 592%
Eyemed Alt Payor [13001] $46 592%
First Health [50007] $46 592%
Global Medical Management [50024] $46 592%
Government Employee Health Association [50023] $46 592%
Guardian Dental [99013] $46 592%
Health Safety Net Dental [99002] $46 592%
Humana $46 592%
Ma Laborers Health And Welfare Fund [50022] $46 592%
Magellan Health Services [65098] $46 592%
Mass Health Dental [99001] $46 592%
Medical Mutual Of Ohio [50019] $46 592%
Metlife Dental [99008] $46 592%
Modern Assistance Program [30098] $46 592%
Mva [90002] $46 592%
Neighborhood Health Plan [50011] $46 592%
Other Bh Payor [50014] $46 592%
Other Commercial Payor [50015] $46 592%
Other Dental Payor [99014] $46 592%
Other Dual Eligible Payer [65004] $46 592%
Other Gov'T Alt [85006] $46 592%
Other Vision Payor [50013] $46 592%
Ri Neighborhood Health Plan [50017] $46 592%
Tricare $46 592%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals