CMS Price Transparency Data
Blood test, complete blood count (CBC)
Facility: Mercy Health Lakeshore Campus
Billing Code: 85025 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85025
- Insurance Median: $57
- Cash Discount Price: $43
- vs. Medicare Baseline: 7.34x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Mercy Health Lakeshore Campus is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.34x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$43
Average discount available for prompt cash payment at this facility.
Insurance Median
$57
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: $43 (553%)
Insurance Median: $57 (734%)
Cash: $43 (553% of Medicare)
Ins. Median: $57 (734% 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 734% of the Medicare baseline (a markup of 634%). 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 | $6 - $56 | 77% |
| Medicaid / KanCare | $6 | 77% |
| Aetna | $8 - $53 | 103% |
| Blue Care Network Advantage | $8 | 103% |
| Medicare (plans) | $8 - $16 | 103% |
| Access Health | $12 | 154% |
| U Of M Health Plan | $12 - $59 | 154% |
| Wellpath | $12 | 154% |
| Align Senior Care | $16 | 206% |
| Correctional Recovery | $16 | 206% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $19 | 245% |
| Oscar | $20 | 257% |
| Vitalcore | $22 | 283% |
| UnitedHealthcare | $23 - $59 | 296% |
| Molina Marketplace | $27 | 347% |
| Hospice Of Michigan | $36 | 463% |
| Nomi Health | $37 | 476% |
| Hap | $49 - $59 | 631% |
| Wc Accident Fund | $52 | 669% |
| Wc Advantage | $52 | 669% |
| Wc Aig | $52 | 669% |
| Wc Allied | $52 | 669% |
| Wc Amerisure | $52 | 669% |
| Wc Amtrust | $52 | 669% |
| Wc Asu Risk Mgt | $52 | 669% |
| Wc Berkley Admin | $52 | 669% |
| Wc Broadspire | $52 | 669% |
| Wc Bunch & Associates | $52 | 669% |
| Wc Ccmsi | $52 | 669% |
| Wc Emc Insurance Company | $52 | 669% |
| Wc Esis | $52 | 669% |
| Wc Fcci | $52 | 669% |
| Wc Federated | $52 | 669% |
| Wc Gallagher Bassett | $52 | 669% |
| Wc Genex Care For Ohio | $52 | 669% |
| Wc Guard Insurance Company | $52 | 669% |
| Wc Hartford | $52 | 669% |
| Wc Liberty Mutual | $52 | 669% |
| Wc Meijers | $52 | 669% |
| Wc Michigan | $52 | 669% |
| Wc Mitchell Frankenmuth | $52 | 669% |
| Wc Pma | $52 | 669% |
| Wc Sedgwick | $52 | 669% |
| Wc Sentry | $52 | 669% |
| Wc Travelers | $52 | 669% |
| Wc Tristar | $52 | 669% |
| Wc Walmart | $52 | 669% |
| Wc Zurich | $52 | 669% |
| Geha | $53 - $59 | 682% |
| Meritain | $53 | 682% |
| Asr Health Benefits | $55 | 708% |
| Bcn Domestic | $56 | 721% |
| Blue Benefit Administrators Of Massachusetts | $56 | 721% |
| Blue Care Network | $56 | 721% |
| Blue Distinction Transplant | $56 | 721% |
| Blue Shield - Ca | $56 | 721% |
| Blue Shield - Id (Regence) | $56 | 721% |
| Blue Shield - Ny Highmark Northeastern | $56 | 721% |
| Blue Shield - Ny Highmark Western | $56 | 721% |
| Blue Shield - Pa (Highmark) | $56 | 721% |
| Blue Shield - Wa (Regence) | $56 | 721% |
| Health Choices | $56 - $59 | 721% |
| Kaiser Domestic | $56 | 721% |
| 1199 National Benefit Fund | $57 | 734% |
| Allied National Global Care | $57 | 734% |
| Asrm - Reliance Standard Life Insurance | $57 | 734% |
| Christian Care Ministry | $57 | 734% |
| Cigna | $57 | 734% |
| Dean Health | $57 | 734% |
| Fallon Health | $57 | 734% |
| Family Life Insurance Company | $57 | 734% |
| Ghc Scw | $57 | 734% |
| Group Pension Administrators | $57 | 734% |
| International Benefit Administrators | $57 | 734% |
| Lifetime Benefit Solutions | $57 | 734% |
| Manhattan Life | $57 | 734% |
| Medi Share | $57 | 734% |
| Multiplan | $57 | 734% |
| Mvp | $57 | 734% |
| Pai | $57 | 734% |
| Pan-American Life | $57 | 734% |
| Paramount Hmo | $57 | 734% |
| Phcs | $57 | 734% |
| Trinity Health Share | $57 | 734% |
| Acclaim | $59 | 759% |
| Administrative Concepts | $59 | 759% |
| Allegeant | $59 | 759% |
| Allied Benefit Systems | $59 | 759% |
| Ameriben | $59 | 759% |
| American Family | $59 | 759% |
| American Healthcare Alliance | $59 | 759% |
| American Republic | $59 | 759% |
| Amerihealth | $59 | 759% |
| Aultcare | $59 | 759% |
| Automated Benefit Services | $59 | 759% |
| Auxiant | $59 | 759% |
| Benefit Administrative Systems,Llc | $59 | 759% |
| Boon Chapman | $59 | 759% |
| Cam Administrative Services | $59 | 759% |
| Caresource | $59 | 759% |
| Christian Brother Services | $59 | 759% |
| Christian Brothers Holy Cross | $59 | 759% |
| Claimchoice Adminstrators | $59 | 759% |
| Comprehensive Benefits | $59 | 759% |
| Consociate | $59 | 759% |
| Continental Life Insurance | $59 | 759% |
| Custom Benefit Administrators | $59 | 759% |
| Cypress Benefit Administrators | $59 | 759% |
| Employee Benefit Concepts | $59 | 759% |
| Employee Benefit Management | $59 | 759% |
| Enterprise Group Planning | $59 | 759% |
| Forest County Potawatomi | $59 | 759% |
| Freedom Life Insurance Company | $59 | 759% |
| Group Administrators | $59 | 759% |
| Group Marketing Services | $59 | 759% |
| Guardian | $59 | 759% |
| Health America | $59 | 759% |
| Health Smart | $59 | 759% |
| Healthez | $59 | 759% |
| Healthgram | $59 | 759% |
| Healthscope | $59 | 759% |
| Humana | $59 | 759% |
| Insight | $59 | 759% |
| Intercare | $59 | 759% |
| Jfp Benefit Management | $59 | 759% |
| Jp Farley Corporation | $59 | 759% |
| Key Benefit Administrator | $59 | 759% |
| Liberty Union Life Assurance Co | $59 | 759% |
| Lucent Health | $59 | 759% |
| Luminare Health | $59 | 759% |
| Luminare Health (Detroit) | $59 | 759% |
| Medben | $59 | 759% |
| Medcost | $59 | 759% |
| Medical Mutual | $59 | 759% |
| Mutual Health Services | $59 | 759% |
| Mutual Of Omaha | $59 | 759% |
| Ncas | $59 | 759% |
| Nippon Life Ins | $59 | 759% |
| Nova | $59 | 759% |
| Painters Union Insurance Fund | $59 | 759% |
| Physicians Mutual | $59 | 759% |
| Plumbers Local 98 Insurance Fund | $59 | 759% |
| Prairie States | $59 | 759% |
| Primary Physician Care | $59 | 759% |
| Priority Health | $59 | 759% |
| Professional Benefit Administrators | $59 | 759% |
| Secureone Preferred United Plans | $59 | 759% |
| The Loomis Company | $59 | 759% |
| Trustmark Small Business Benefits | $59 | 759% |
| Unicare | $59 | 759% |
| Unified Group Services | $59 | 759% |
| Us Health And Life | $59 | 759% |
| Valenz | $59 | 759% |
| Varipro | $59 | 759% |
| Western & Southern Financial Group | $59 | 759% |
| Wps | $59 | 759% |
| First Health | $60 | 772% |