CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Pender Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $462
Cash Discount Price: $749
vs. Medicare Baseline: 59.46x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Pender Memorial Hospital is $462. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $749. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 59.46x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$749

Average discount available for prompt cash payment at this facility.

Insurance Median

$462

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: $749 (9640%)

Insurance Median: $462 (5946%)

Cash: $749 (9640% of Medicare)

Ins. Median: $462 (5946% 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 5946% of the Medicare baseline (a markup of 5846%). 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
Humana	$25 - $2,778	322%
Aetna	$27 - $2,746	347%
Blue Cross Blue Shield	$27 - $2,326	347%
New Hanover Health	$27 - $890	347%
Pace Of The Southern Piedmont	$27 - $872	347%
Amerihealth	$28 - $925	360%
Carolina Complete	$28 - $907	360%
Cigna	$28 - $1,424	360%
Nc Department Of Public Safety	$28 - $1,744	360%
Wellcare	$28 - $925	360%
Ambetter / Centene	$37 - $1,221	476%
Liberty Health	$38 - $1,239	489%
Caresource North Carolina	$40 - $1,292	515%
Plotkin Health	$59 - $1,938	759%
UnitedHealthcare	$72 - $2,358	927%
Medcost	$75 - $2,710	965%
Employers Choice Network	$96 - $3,133	1236%
Three Rivers Provider Network	$96 - $3,133	1236%

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 $749.
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 Pender Memorial 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.