CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: St Joseph's University Medical Center Inc

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $16
  • Cash Discount Price: $151
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at St Joseph's University Medical Center Inc is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.06x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$151

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $151 (1943%)
Insurance Median: $16 (206%)
Cash: $151 (1943% of Medicare)
Ins. Median: $16 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
Consumer Health Network $5 - $136 64%
UnitedHealthcare $5 - $16 64%
Wellpoint $5 - $8 64%
Aetna $8 - $31 103%
Amerihealth $8 - $96 103%
Blue Cross Blue Shield $8 - $132 103%
Clover Health $8 103%
Fidelis Care of New Jersey $8 - $30 103%
Horizon New Jersey Health $8 103%
Horizon New Jersey Total Care $8 103%
Longevity Health Plan $9 116%
Ambetter / Centene $12 154%
Oxford $16 206%
Private Healthcare Systems $98 1261%
Magnacare $106 1364%
Multiplan $113 1454%
Oscar $142 1828%
Cigna $151 1943%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals