CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Hermann Area District Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $64
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 8.24x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Hermann Area District Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 8.24x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $66 (849%)
Insurance Median: $64 (824%)
Cash: $66 (849% of Medicare)
Ins. Median: $64 (824% 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 824% of the Medicare baseline (a markup of 724%). 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
Coventry - All Plans $9 116%
UnitedHealthcare $12 - $46 154%
Tricare $44 566%
Cigna $45 579%
Choicecare Mcr Adv- All Plans $46 592%
American Hlth Mcr Adv- All Plans $48 618%
Blue Cross Blue Shield $48 - $90 618%
Humana $48 618%
Aetna $49 - $104 631%
Wellcare Mcr Adv - All Plans $49 631%
Harmony Hp Mcaid- All Plans $64 824%
Healthcare Usa Mcaid- All Plans $72 927%
Healthlink Hmo $72 927%
Ambetter / Centene $77 991%
Healthlink Ppo - All Other Plans $82 1055%
Multiplan/Phcs - All Plans $82 1055%
Comp Results - All Plans $99 1274%
Three Rivers - All Plans $99 1274%
Care Partners Mcaid- All Plans $110 1416%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals