CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: St James Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $7
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at St James Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 0.90x the Medicare baseline. Located in 411 Canisteo Street, Hornell, NY.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $38 (489%)
Insurance Median: $7 (90%)
Cash: $38 (489% of Medicare)
Ins. Median: $7 (90% 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
Blue Cross Blue Shield $3 - $15 39%
Fidelis 5155 $3 39%
Medicaid / KanCare $3 - $7 39%
Molina Healthcare 1723 $3 - $7 39%
UnitedHealthcare $3 - $8 39%
Cigna $7 90%
Medicare (plans) $7 - $8 90%
Mvp 2900 $7 90%
Aetna $8 - $12 103%
Humana $8 103%
Empire Plan 5179 $9 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 411 Canisteo Street, Hornell, NY 14843
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals