CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: St Francis Hospital - the Heart Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $17
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.19x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at St Francis Hospital - the Heart Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.19x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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%)
Insurance Median: $17 (219%)
Ins. Median: $17 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Affinity Health Plan $3 - $7 39%
Centerlight Healthcare $3 - $8 39%
Elderplan Inc. $3 - $8 39%
Emblem Health $3 - $17 39%
Fidelis Care New York $3 - $8 39%
Health First $3 - $17 39%
Health Plus $3 - $8 39%
Independent Health $3 - $8 39%
Medicaid / KanCare $3 39%
Mvp Health Plans $3 - $19 39%
Senior Whole Health $3 - $8 39%
UnitedHealthcare $3 - $29 39%
Aetna $8 - $11 103%
Agewell New York $8 103%
Blue Cross Blue Shield $8 - $29 103%
Centers Plan For Healthy Living $8 103%
Healthspring $8 103%
Humana $8 103%
Liberty Health $8 103%
Longevity Health Plan $8 103%
Medicare (plans) $8 103%
Orthonet - Uniformed Services Family Health Plan $8 103%
Partners Health Plan $8 103%
Pmc $8 103%
Surest $8 103%
Tricare $8 103%
Universal Healthcare $8 103%
Us Family Health Plan $8 103%
Veterans Affairs $8 103%
Wellcare Health Plan Inc $9 116%
Zadroga $10 129%
Mail Handlers Benefit Plan $11 142%
Meritain Health $11 142%
Nippon Life Insurance Company Of America $11 142%
Salvation Army $11 142%
Centivo $12 - $19 154%
American Plan Administrators $17 219%
Amerihealth Administrators $17 219%
Benefit Services $17 219%
Ghi Cbp Ny City Employee Alternate $17 219%
International Benefit Administrator $17 219%
Ultra Benefits Inc. $17 219%
Apwu $19 245%
Cigna $19 - $177 245%
Daniel H Cook $19 245%
Nalc $19 245%
Samba $19 245%
Brighton $20 - $177 257%
Self Pay $29 373%
Local 1199 $44 566%
Oscar Health $57 - $104 734%
Allied Wellfare Fund $97 - $177 1248%
American Group Administrators $97 - $177 1248%
Bakery & Confectionery Union $97 - $177 1248%
Comprehensive Benefits Consultant $97 - $177 1248%
Guardian Life Insurance Company Of America $97 - $177 1248%
Maloney And Assoc $97 - $177 1248%
Multiplan $97 - $177 1248%
Performax $97 - $177 1248%
Phcs $97 - $177 1248%
Pomco $97 - $177 1248%
Tpa Inc $97 - $177 1248%
Unicare $97 - $177 1248%
United Employees Health Plan $97 - $177 1248%
Coventry $103 - $210 1326%
Galaxy $125 - $228 1609%
Three Rivers Provider Network $125 - $228 1609%
Aither Health $139 - $253 1789%
Alpha Care $139 - $253 1789%
Dentaquest $139 - $253 1789%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals