CMS Price Transparency Data
Blood test, complete blood count (CBC)
Facility: Trinity Health Muskegon Hospital
Billing Code: 85025 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85025
- Insurance Median: $35
- Cash Discount Price: $180
- vs. Medicare Baseline: 4.50x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Trinity Health Muskegon Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 4.50x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$180
Average discount available for prompt cash payment at this facility.
Insurance Median
$35
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: $180 (2317%)
Insurance Median: $35 (450%)
Cash: $180 (2317% of Medicare)
Ins. Median: $35 (450% 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 450% of the Medicare baseline (a markup of 350%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $4 - $10 | 51% |
| Medicaid / KanCare | $4 | 51% |
| Access Health | $5 | 64% |
| Aetna | $8 - $28 | 103% |
| Align Senior Care | $8 | 103% |
| Blue Care Network Advantage | $8 | 103% |
| Correctional Recovery | $8 | 103% |
| Heartland Hospice | $8 | 103% |
| Hospice Harbor Hospice | $8 | 103% |
| Medicare (plans) | $8 | 103% |
| Oscar | $8 | 103% |
| UnitedHealthcare | $8 - $58 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $9 | 116% |
| Bcn Domestic | $10 | 129% |
| Blue Benefit Administrators Of Massachusetts | $10 | 129% |
| Blue Care Network | $10 | 129% |
| Blue Distinction Transplant | $10 | 129% |
| Blue Shield - Ca | $10 | 129% |
| Blue Shield - Id (Regence) | $10 | 129% |
| Blue Shield - Ny Highmark Northeastern | $10 | 129% |
| Blue Shield - Ny Highmark Western | $10 | 129% |
| Blue Shield - Pa (Highmark) | $10 | 129% |
| Blue Shield - Wa (Regence) | $10 | 129% |
| Health Choices | $10 - $52 | 129% |
| Kaiser Domestic | $10 | 129% |
| Molina Marketplace | $10 | 129% |
| Geha | $12 - $58 | 154% |
| Meritain | $12 | 154% |
| U Of M Health Plan | $12 - $52 | 154% |
| Vitalcore | $12 | 154% |
| Wellpath | $12 | 154% |
| Acs Benefit Services | $34 | 438% |
| Allied Benefit Systems | $34 | 438% |
| Claimchoice Adminstrators | $34 | 438% |
| Consociate | $34 | 438% |
| Cypress Benefit Administrators | $34 | 438% |
| Forest County Potawatomi | $34 | 438% |
| Health Smart | $34 | 438% |
| Healthgram | $34 | 438% |
| Healthscope | $34 | 438% |
| Preferred One | $34 | 438% |
| Secureone Preferred United Plans | $34 | 438% |
| Sisco Benefits | $34 | 438% |
| The Health Plan | $34 | 438% |
| Trustmark Small Business Benefits | $34 | 438% |
| Unified Group Services | $34 | 438% |
| Webtpa | $34 | 438% |
| Asr Health Benefits | $35 | 450% |
| Hap | $35 - $52 | 450% |
| Wc Accident Fund | $35 | 450% |
| Wc Advantage | $35 | 450% |
| Wc Aig | $35 | 450% |
| Wc Allied | $35 | 450% |
| Wc Amerisure | $35 | 450% |
| Wc Amtrust | $35 | 450% |
| Wc Asu Risk Mgt | $35 | 450% |
| Wc Berkley Admin | $35 | 450% |
| Wc Broadspire | $35 | 450% |
| Wc Bunch & Associates | $35 | 450% |
| Wc Ccmsi | $35 | 450% |
| Wc Emc Insurance Company | $35 | 450% |
| Wc Esis | $35 | 450% |
| Wc Fcci | $35 | 450% |
| Wc Federated | $35 | 450% |
| Wc Gallagher Bassett | $35 | 450% |
| Wc Genex Care For Ohio | $35 | 450% |
| Wc Guard Insurance Company | $35 | 450% |
| Wc Hartford | $35 | 450% |
| Wc Liberty Mutual | $35 | 450% |
| Wc Meijers | $35 | 450% |
| Wc Michigan | $35 | 450% |
| Wc Mitchell Frankenmuth | $35 | 450% |
| Wc Pma | $35 | 450% |
| Wc Sedgwick | $35 | 450% |
| Wc Sentry | $35 | 450% |
| Wc Travelers | $35 | 450% |
| Wc Tristar | $35 | 450% |
| Wc Walmart | $35 | 450% |
| Wc Zurich | $35 | 450% |
| Hospice Of Michigan | $36 | 463% |
| Nomi Health | $37 | 476% |
| Varipro | $38 | 489% |
| Priority Health | $40 - $45 | 515% |
| Caresource | $42 | 541% |
| Cigna | $42 | 541% |
| 1199 National Benefit Fund | $50 | 644% |
| Allied National Global Care | $50 | 644% |
| Asrm - Reliance Standard Life Insurance | $50 | 644% |
| Christian Care Ministry | $50 | 644% |
| Dean Health | $50 | 644% |
| Fallon Health | $50 | 644% |
| Family Life Insurance Company | $50 | 644% |
| Ghc Scw | $50 | 644% |
| Group Pension Administrators | $50 | 644% |
| International Benefit Administrators | $50 | 644% |
| Lifetime Benefit Solutions | $50 | 644% |
| Manhattan Life | $50 | 644% |
| Medi Share | $50 | 644% |
| Multiplan | $50 | 644% |
| Mvp | $50 | 644% |
| Pai | $50 | 644% |
| Pan-American Life | $50 | 644% |
| Paramount Hmo | $50 | 644% |
| Phcs | $50 | 644% |
| Trinity Health Share | $50 | 644% |
| Acclaim | $52 | 669% |
| Administrative Concepts | $52 | 669% |
| Allegeant | $52 | 669% |
| Ameriben | $52 | 669% |
| American Family | $52 | 669% |
| American Healthcare Alliance | $52 | 669% |
| American Republic | $52 | 669% |
| Amerihealth | $52 | 669% |
| Aultcare | $52 | 669% |
| Automated Benefit Services | $52 | 669% |
| Auxiant | $52 | 669% |
| Benefit Administrative Systems,Llc | $52 | 669% |
| Boon Chapman | $52 | 669% |
| Cam Administrative Services | $52 | 669% |
| Christian Brother Services | $52 | 669% |
| Christian Brothers Holy Cross | $52 | 669% |
| Comprehensive Benefits | $52 | 669% |
| Continental Life Insurance | $52 | 669% |
| Custom Benefit Administrators | $52 | 669% |
| Employee Benefit Concepts | $52 | 669% |
| Employee Benefit Management | $52 | 669% |
| Enterprise Group Planning | $52 | 669% |
| Freedom Life Insurance Company | $52 | 669% |
| Group Administrators | $52 | 669% |
| Group Marketing Services | $52 | 669% |
| Guardian | $52 | 669% |
| Health America | $52 | 669% |
| Healthez | $52 | 669% |
| Humana | $52 | 669% |
| Insight | $52 | 669% |
| Intercare | $52 | 669% |
| Jfp Benefit Management | $52 | 669% |
| Jp Farley Corporation | $52 | 669% |
| Key Benefit Administrator | $52 | 669% |
| Liberty Union Life Assurance Co | $52 | 669% |
| Lucent Health | $52 | 669% |
| Luminare Health | $52 | 669% |
| Luminare Health (Detroit) | $52 | 669% |
| Medben | $52 | 669% |
| Medcost | $52 | 669% |
| Medical Mutual | $52 | 669% |
| Mutual Health Services | $52 | 669% |
| Mutual Of Omaha | $52 | 669% |
| Ncas | $52 | 669% |
| Nippon Life Ins | $52 | 669% |
| Nova | $52 | 669% |
| Painters Union Insurance Fund | $52 | 669% |
| Physicians Mutual | $52 | 669% |
| Plumbers Local 98 Insurance Fund | $52 | 669% |
| Prairie States | $52 | 669% |
| Primary Physician Care | $52 | 669% |
| Professional Benefit Administrators | $52 | 669% |
| The Loomis Company | $52 | 669% |
| Unicare | $52 | 669% |
| Us Health And Life | $52 | 669% |
| Valenz | $52 | 669% |
| Western & Southern Financial Group | $52 | 669% |
| Wps | $52 | 669% |
| First Health | $54 | 695% |
| Barinet | $66 | 849% |
| Cmh Allegan County | $66 | 849% |
| Cmh Barry County | $66 | 849% |
| Cmh Berrien County | $66 | 849% |
| Cmh Cass County | $66 | 849% |
| Cmh Kalamazoo | $66 | 849% |
| Cmh Kent County | $66 | 849% |
| Cmh Misc | $66 | 849% |
| Cmh Muskegon County | $66 | 849% |
| Cmh North Country | $66 | 849% |
| Cmh Northern Lakes County | $66 | 849% |
| Cmh Ottawa County | $66 | 849% |
| Cmh Van Buren County | $66 | 849% |
| Cmh West Mi County | $66 | 849% |