CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Licking Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $66
  • Cash Discount Price: $110
  • vs. Medicare Baseline: 8.49x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Licking Memorial Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 8.49x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$110

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $110 (1416%)
Insurance Median: $66 (849%)
Cash: $110 (1416% of Medicare)
Ins. Median: $66 (849% 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 849% of the Medicare baseline (a markup of 749%). 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
Aetna $8 - $107 103%
Blue Cross Blue Shield $8 - $126 103%
Champva [500001] $8 103%
Cigna $8 - $132 103%
Humana $8 - $143 103%
Medicare (plans) $8 103%
Tricare $8 103%
UnitedHealthcare $8 - $125 103%
Veterans Administration [100068] $8 103%
Wellcare By Allwell [450104] $8 103%
Molina Marketplace [100106] $12 154%
Medical Mutual [100114] $41 - $122 528%
Medben [700068] $52 - $144 669%
Allied Benefit Systems [100015] $53 - $106 682%
Geha [100039] $53 - $106 682%
Gravie Administrative Services [100165] $53 - $106 682%
Meritain [100063] $53 - $106 682%
Optima [700069] $53 - $106 682%
Trustmark Small Business Benefits [100263] $53 - $106 682%
Webtpa [100127] $53 - $106 682%
Benicomp [70090] $55 - $110 708%
Consociate Health 6 Degrees [100059] $59 - $118 759%
Consociate Health [100029] $59 - $118 759%
Healthscope [100157] $63 - $125 811%
Surest [100016] $63 - $125 811%
United Medical Resources [700071] $63 - $125 811%
American Postal Workers [100089] $66 - $132 849%
Antidote Health Plan Of Ohio [70006803] $66 - $132 849%
Coresource [100002] $66 - $147 849%
Great West Life [700064] $66 - $132 849%
National Association Of Letter Carriers [100067] $66 - $132 849%
Ohio Healthy Luminare Health [100264] $66 - $132 849%
Ohio Healthy [100255] $66 - $132 849%
Ohio Ppo Connect [70006801] $66 - $132 849%
Osu Prime Care [100254] $66 - $132 849%
Quality Care Partners [70006802] $66 - $132 849%
The Health Plan [100261] $66 - $132 849%
Wellfleet Group, Llc [100164] $66 - $132 849%
Coventry [100010] $68 - $136 875%
Pan American Life [700070] $68 - $136 875%
Ohio Health Choice [100109] $71 - $141 914%
Administrative Concepts [100006] $72 - $143 927%
Carefactor [100087] $72 - $143 927%
Philadelphia American Life [100260] $72 - $147 927%
Reliance Standard-Asrm [100258] $72 - $143 927%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals