CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Wooster Community Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $42
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 5.41x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Wooster Community Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 5.41x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $50 (644%)
Insurance Median: $42 (541%)
Cash: $50 (644% of Medicare)
Ins. Median: $42 (541% 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 541% of the Medicare baseline (a markup of 441%). 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
Blue Cross Blue Shield $6 - $8 77%
Buckeye Mcaid-All Other Plans $7 90%
Caresource Mcaid $7 90%
UnitedHealthcare $7 - $48 90%
Aetna $8 - $51 103%
Amerihealth Mcaid-All Plans $8 103%
Buckeye Mcare $8 103%
Caresource Mcr Adv $8 103%
Humana $8 - $48 103%
Med Mutual Of Oh Mcr $8 103%
Molina Mcaid $8 103%
Molina Mcr $8 103%
Summacare Mcr $8 103%
The Health Plan Mcr Adv $8 103%
Tricare $8 103%
Valor Hp Mcr-All Plans $8 103%
Magnipower-All Plans $10 129%
Caresource Exch - All Other Plans $11 142%
Molina Marketplace - All Other Plans $13 167%
Clarity Health - All Plans $15 193%
Aultcare/Primecare Mcr Adv $24 - $25 309%
Cerco-All Plans $34 - $35 438%
Aultcare Wayne County $37 - $38 476%
Aultcare/Primetime Exch $37 - $38 476%
Rayco-All Plans $37 - $38 476%
Christian Health Ministries-All Plans $39 - $41 502%
Cigna $39 - $41 502%
Health Ohio Network Employer $39 - $41 502%
Wayne County-All Plans $39 - $41 502%
Healthsmart Accel $41 - $42 528%
Summacare Preferred Choice $41 - $42 528%
Health Ohio Network Ppo-All Other Plans $42 - $43 541%
Healthsmart Complete Ppo-All Other Plans $42 - $43 541%
Med Mutual Of Oh Exchange $42 - $44 541%
Med Mutual Of Oh Supermed $42 - $44 541%
Med Mutual Of Oh Trad-All Other Plans $42 - $44 541%
Ohio Health Choice Supp $42 - $43 541%
Ohio Health Group Hlthy - All Other Plans $42 - $43 541%
Health Plan Of Upper Ohio-All Plans $43 - $45 553%
The Health Plan Comm - All Other Plans $43 - $45 553%
Aultcare/Primetime-All Other Plans $44 - $46 566%
Ohio Health Group Pref $44 - $45 566%
Healthsmart Ppo $45 - $46 579%
Healthsmart Hpo $46 - $48 592%
Ohio Health Choice-All Other Plans $46 - $48 592%
Osu-All Plans $46 - $48 592%
Summacare-All Other Plans $46 - $47 592%
Beech Street-All Plans $47 - $49 605%
Central Benefits-All Plans $47 - $49 605%
First Health-All Plans $47 - $49 605%
Flora-All Plans $47 - $49 605%
Phcs-All Plans $47 - $49 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals