CMS Price Transparency Data
Blood test, complete blood count (CBC)
Facility: Trinity Health Oakland Hospital
Billing Code: 85025 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85025
- Insurance Median: $51
- Cash Discount Price: $49
- vs. Medicare Baseline: 6.56x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Trinity Health Oakland Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 6.56x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$49
Average discount available for prompt cash payment at this facility.
Insurance Median
$51
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: $49 (631%)
Insurance Median: $51 (656%)
Cash: $49 (631% of Medicare)
Ins. Median: $51 (656% 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 656% of the Medicare baseline (a markup of 556%). 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.
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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 | $4 - $8 | 51% |
| Medicaid / KanCare | $4 | 51% |
| Aetna | $8 - $34 | 103% |
| Align Senior Care | $8 | 103% |
| Bcn Domestic | $8 | 103% |
| Blue Benefit Administrators Of Massachusetts | $8 | 103% |
| Blue Care Network | $8 | 103% |
| Blue Care Network Advantage | $8 | 103% |
| Blue Distinction Transplant | $8 | 103% |
| Blue Shield - Ca | $8 | 103% |
| Blue Shield - Id (Regence) | $8 | 103% |
| Blue Shield - Ny Highmark Northeastern | $8 | 103% |
| Blue Shield - Ny Highmark Western | $8 | 103% |
| Blue Shield - Pa (Highmark) | $8 | 103% |
| Blue Shield - Wa (Regence) | $8 | 103% |
| Cca - Zing Health | $8 | 103% |
| Health Choices | $8 - $55 | 103% |
| Hospice Advantage | $8 | 103% |
| Kaiser Domestic | $8 | 103% |
| Medicare (plans) | $8 | 103% |
| UnitedHealthcare | $8 - $56 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $9 | 116% |
| Molina Marketplace | $10 | 129% |
| Geha | $12 - $56 | 154% |
| Health Cost Solutions | $12 | 154% |
| Medical Mutual | $12 | 154% |
| Meritain | $12 | 154% |
| Priority Health | $12 - $13 | 154% |
| U Of M Health Plan | $12 | 154% |
| Vitalcore | $12 | 154% |
| Wellpath | $12 | 154% |
| Employee Benefit Logistic | $17 | 219% |
| Wc Accident Fund | $23 | 296% |
| Wc Advantage | $23 | 296% |
| Wc Aig | $23 | 296% |
| Wc Allied | $23 | 296% |
| Wc Amerisure | $23 | 296% |
| Wc Amtrust | $23 | 296% |
| Wc Asu Risk Mgt | $23 | 296% |
| Wc Berkley Admin | $23 | 296% |
| Wc Broadspire | $23 | 296% |
| Wc Bunch & Associates | $23 | 296% |
| Wc Ccmsi | $23 | 296% |
| Wc Emc Insurance Company | $23 | 296% |
| Wc Esis | $23 | 296% |
| Wc Fcci | $23 | 296% |
| Wc Federated | $23 | 296% |
| Wc Gallagher Bassett | $23 | 296% |
| Wc Genex Care For Ohio | $23 | 296% |
| Wc Guard Insurance Company | $23 | 296% |
| Wc Hartford | $23 | 296% |
| Wc Liberty Mutual | $23 | 296% |
| Wc Meijers | $23 | 296% |
| Wc Michigan | $23 | 296% |
| Wc Mitchell Frankenmuth | $23 | 296% |
| Wc Pma | $23 | 296% |
| Wc Sedgwick | $23 | 296% |
| Wc Sentry | $23 | 296% |
| Wc Travelers | $23 | 296% |
| Wc Tristar | $23 | 296% |
| Wc Walmart | $23 | 296% |
| Wc Zurich | $23 | 296% |
| Asr Health Benefits | $26 | 335% |
| Caresource | $26 | 335% |
| Hap | $26 - $55 | 335% |
| Varipro | $26 | 335% |
| Acs Benefit Services | $33 | 425% |
| Allied Benefit Systems | $33 | 425% |
| Claimchoice Adminstrators | $33 | 425% |
| Consociate | $33 | 425% |
| Cypress Benefit Administrators | $33 | 425% |
| Forest County Potawatomi | $33 | 425% |
| Health Smart | $33 | 425% |
| Healthgram | $33 | 425% |
| Healthscope | $33 | 425% |
| Secureone Preferred United Plans | $33 | 425% |
| Sisco Benefits | $33 | 425% |
| The Health Plan | $33 | 425% |
| Trustmark Small Business Benefits | $33 | 425% |
| Unified Group Services | $33 | 425% |
| Webtpa | $33 | 425% |
| Mclaren Health | $36 - $39 | 463% |
| Carelon Behavioral Health | $38 | 489% |
| Magellan Behavioral Health | $45 | 579% |
| 1199 National Benefit Fund | $51 | 656% |
| Allied National Global Care | $51 | 656% |
| Asrm - Reliance Standard Life Insurance | $51 | 656% |
| Christian Care Ministry | $51 | 656% |
| Dean Health | $51 | 656% |
| Fallon Health | $51 | 656% |
| Family Life Insurance Company | $51 | 656% |
| Ghc Scw | $51 | 656% |
| Group Pension Administrators | $51 | 656% |
| International Benefit Administrators | $51 | 656% |
| Lifetime Benefit Solutions | $51 | 656% |
| Manhattan Life | $51 | 656% |
| Medi Share | $51 | 656% |
| Multiplan | $51 | 656% |
| Mvp | $51 | 656% |
| Pai | $51 | 656% |
| Pan-American Life | $51 | 656% |
| Paramount Hmo | $51 | 656% |
| Phcs | $51 | 656% |
| Trinity Health Share | $51 | 656% |
| Access Health | $55 | 708% |
| Acclaim | $55 | 708% |
| Administrative Concepts | $55 | 708% |
| Allegeant | $55 | 708% |
| Ameriben | $55 | 708% |
| American Family | $55 | 708% |
| American Healthcare Alliance | $55 | 708% |
| American National | $55 | 708% |
| American Republic | $55 | 708% |
| Amerihealth | $55 | 708% |
| Aultcare | $55 | 708% |
| Automated Benefit Services | $55 | 708% |
| Auxiant | $55 | 708% |
| Benefit Administrative Systems,Llc | $55 | 708% |
| Boon Chapman | $55 | 708% |
| Cam Administrative Services | $55 | 708% |
| Christian Brother Services | $55 | 708% |
| Christian Brothers Holy Cross | $55 | 708% |
| Comprehensive Benefits | $55 | 708% |
| Continental Life Insurance | $55 | 708% |
| Custom Benefit Administrators | $55 | 708% |
| Employee Benefit Concepts | $55 | 708% |
| Employee Benefit Management | $55 | 708% |
| Enterprise Group Planning | $55 | 708% |
| Freedom Life Insurance Company | $55 | 708% |
| Group Administrators | $55 | 708% |
| Group Marketing Services | $55 | 708% |
| Guardian | $55 | 708% |
| Health America | $55 | 708% |
| Health Partners | $55 | 708% |
| Healthcare Management Admin | $55 | 708% |
| Healthez | $55 | 708% |
| Humana | $55 | 708% |
| Insight | $55 | 708% |
| Intercare | $55 | 708% |
| Jfp Benefit Management | $55 | 708% |
| Jp Farley Corporation | $55 | 708% |
| Key Benefit Administrator | $55 | 708% |
| Liberty Union Life Assurance Co | $55 | 708% |
| Lucent Health | $55 | 708% |
| Luminare Health | $55 | 708% |
| Luminare Health (Detroit) | $55 | 708% |
| Magnacare | $55 | 708% |
| Medben | $55 | 708% |
| Medcost | $55 | 708% |
| Mutual Health Services | $55 | 708% |
| Mutual Of Omaha | $55 | 708% |
| Ncas | $55 | 708% |
| Nippon Life Ins | $55 | 708% |
| Nova | $55 | 708% |
| Painters Union Insurance Fund | $55 | 708% |
| Physicians Mutual | $55 | 708% |
| Plumbers Local 98 Insurance Fund | $55 | 708% |
| Prairie States | $55 | 708% |
| Preferred One | $55 | 708% |
| Primary Physician Care | $55 | 708% |
| Professional Benefit Administrators | $55 | 708% |
| Siho Insurance Services | $55 | 708% |
| The Loomis Company | $55 | 708% |
| Tufts Health Plan | $55 | 708% |
| Unicare | $55 | 708% |
| Us Health And Life | $55 | 708% |
| Valenz | $55 | 708% |
| Western & Southern Financial Group | $55 | 708% |
| Wps | $55 | 708% |
| Cigna | $56 | 721% |
| Coventry | $57 | 734% |
| First Health | $57 | 734% |
| Prime Health Services | $60 | 772% |
| Three Rivers Provider Network | $68 | 875% |
| Cmh Detroit Wayne Integrated Health Network | $75 | 965% |
| Cmh Lenawee County | $75 | 965% |
| Cmh Livingston County | $75 | 965% |
| Cmh Misc | $75 | 965% |
| Cmh Monroe County | $75 | 965% |
| Cmh Oakland County | $75 | 965% |
| Cmh Washtenaw County | $75 | 965% |