CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: North Carolina Baptist Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $58
Cash Discount Price: $86
vs. Medicare Baseline: 7.46x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at North Carolina Baptist Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.46x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $86 (1107%)

Insurance Median: $58 (746%)

Cash: $86 (1107% of Medicare)

Ins. Median: $58 (746% 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 746% of the Medicare baseline (a markup of 646%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$8 - $150	103%
Apex	$8	103%
Blue Cross Blue Shield	$8 - $65	103%
Cigna	$8 - $106	103%
Devoted	$8	103%
Healthteam	$8	103%
Humana	$8 - $97	103%
Medicare (plans)	$8	103%
UnitedHealthcare	$8 - $61	103%
Wellcare	$8 - $14	103%
Liberty	$9	116%
Alliance	$14	180%
Amerihealth	$14 - $42	180%
Carolina Complete	$14	180%
Health Blue	$14	180%
Medcost	$14 - $118	180%
Partners	$14	180%
Vaya	$14	180%
Trillium	$15	193%
Ambetter / Centene	$38 - $40	489%
Oscar	$50 - $64	644%
Directnet	$99 - $105	1274%
Cone Health	$117 - $124	1506%
Healthgram	$117 - $124	1506%
First Carolina Care	$134 - $142	1725%
Private Healthcare Systems	$137 - $145	1763%
Multiplan	$150 - $159	1931%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $86.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

Insurance In-Network Protection Plan

Contact your insurance company to confirm North Carolina Baptist Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85025.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.