CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $16
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Munson Healthcare Otsego Memorial Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.06x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $68 (875%)
Insurance Median: $16 (206%)
Cash: $68 (875% of Medicare)
Ins. Median: $16 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
UnitedHealthcare $3 - $64 39%
Blue Cross Blue Shield $4 - $50 51%
Mclaren Health Plan $4 - $67 51%
Meridian $4 51%
Molina $4 - $8 51%
Priority Health $4 - $19 51%
Aetna $7 - $65 90%
Blue Care Network $8 103%
Cigna $8 - $19 103%
Hap (Health Alliance Plan) $8 - $64 103%
Humana $8 103%
Medicare (plans) $8 103%
Michigan Amish Medical Board $8 103%
Northern Michigan Mennonite Group $8 103%
Employee Benefit Logistics $13 167%
Hospice Of Michigan $48 618%
Munson Hospice $56 - $852 721%
Asr Physicians Care Network $64 824%
Enterprise Group Planning/Employee Benefit Plan $64 824%
Nomi Health $64 824%
Cofinity $68 - $72 875%
Provider Network Of America/Hawaii Mainland Administrative Group Health $68 875%
Three Rivers Provider Network $68 875%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals