Blood test, complete blood count (CBC)
Facility: Golden Valley Memorial Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $8
- Cash Discount Price: $81
- vs. Medicare Baseline: 1.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $8 | 103% |
| Home State Health | $8 | 103% |
| Humana | $8 | 103% |
| UnitedHealthcare | $8 - $13 | 103% |
| Ambetter / Centene | $9 | 116% |
Consumer Guidance & Cost Commentary
For patients paying out of pocket, the most important fact to know is that the cash price for this blood test is $81, which is significantly lower than the facility's standard chargemaster rate of $135. Because this service is billed at a cash rate, patients with high-deductible plans may find this direct payment option more affordable than using insurance, especially if the negotiated rate allowed by their insurer exceeds the cash price. It is always advisable to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes reduce the final amount owed.
In the broader context of pricing, the facility's cash rate of $81 is notably higher than the state of Missouri average for this procedure, which sits at $8. While the facility offers a negotiated rate of $8 for in-network patients through carriers like Aetna, Home State Health, Humana, and others, this rate is still well above the state average. The Medicare benchmark for this service is $7.77, which serves as a baseline for fair pricing; commercial rates often exceed this by a significant margin due to administrative costs and contract structures. If you are receiving care from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, but federal protections like the No Surprises Act can help prevent surprise bills for emergency or non-emergency services at in-network facilities.