CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $4
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 0.51x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Montefiore Mount Vernon Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 0.51x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $23 (296%)
Insurance Median: $4 (51%)
Cash: $23 (296% of Medicare)
Ins. Median: $4 (51% 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.

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
Wellcare $2 - $3 26%
Amidacare $3 - $4 39%
Blue Cross Blue Shield $3 - $28 39%
Centerlight $3 - $4 39%
Emblem $3 - $28 39%
Fidelis $3 - $6 39%
Healthfirst $3 - $5 39%
Longevity $3 39%
Medicaid / KanCare $3 39%
Point Comfort $3 39%
UnitedHealthcare $3 - $16 39%
Villagecaremax $3 39%
Vnsny Choice $3 - $4 39%
Humana $4 51%
Metroplus $4 51%
Vnsny Select Health $4 51%
Oscar $5 64%
Mvp $7 90%
American Postal Workers $16 206%
Centivo $22 283%
Elderplan $28 360%
Aetna $35 - $39 450%
Cigna $76 - $84 978%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals