CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Roundup Memorial Healthcare

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $92
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 11.84x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Roundup Memorial Healthcare is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 11.84x the Medicare baseline. Located in 1202 3Rd St W, Roundup, MT.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $97 (1248%)
Insurance Median: $92 (1184%)
Cash: $97 (1248% of Medicare)
Ins. Median: $92 (1184% 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 1184% of the Medicare baseline (a markup of 1084%). 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 $8 103%
Tricare $48 618%
Va Ccn - All Plans $48 618%
Geha-All Plans $80 1030%
Blue Cross Blue Shield $87 - $97 1120%
Ebms (Rmhn Network) - All Plans $92 1184%
Pacific Source-All Plans $92 1184%
First Choice-All Plans $94 1210%
Montana Health Co-Op Ppo/Pos - All Plans $94 1210%
Multiplan-All Plans $94 1210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1202 3Rd St W, Roundup, MT 59072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals