CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Boston Children's Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $99
Cash Discount Price: $140
vs. Medicare Baseline: 12.74x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Boston Children's Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 12.74x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $140 (1802%)

Insurance Median: $99 (1274%)

Cash: $140 (1802% of Medicare)

Ins. Median: $99 (1274% 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 1274% of the Medicare baseline (a markup of 1174%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$28 - $92	360%
Unicare	$31	399%
Cdphp	$69 - $119	888%
Harvard Pilgrim	$71 - $95	914%
Aetna	$84 - $117	1081%
United	$84 - $117	1081%
Mgb/Allways	$85 - $104	1094%
Tufts Public Plan	$86	1107%
Ambetter / Centene	$88	1133%
United Ri Nj Ny	$88	1133%
Carelon Strategies/Bhs	$91	1171%
UnitedHealthcare	$91 - $119	1171%
Carelon/Beacon	$105	1351%
Fallon	$107 - $108	1377%
Health New England	$113	1454%
Cigna	$119 - $126	1532%
Ets/Lifetrac	$119	1532%
Interlink Transplant	$119	1532%
Community Health Options	$126	1622%
Humana	$126	1622%
Coventry/Hcvm/First Health	$129	1660%
Multiplan/Phcs	$129 - $133	1660%

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 $140.
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 Boston Children's Hospital 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.