CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Mercy Hospital Ada

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $16
  • Cash Discount Price: $18
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Mercy Hospital Ada is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.06x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$18

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $18 (232%)
Insurance Median: $16 (206%)
Cash: $18 (232% of Medicare)
Ins. Median: $16 (206% 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 206% of the Medicare baseline (a markup of 106%). 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 $7 - $20 90%
Humana $7 - $8 90%
Medicaid / KanCare $7 - $10 90%
Blue Cross Blue Shield $8 103%
Cherokee Nation Health Serv Contracted [320066] $8 103%
Cigna $8 103%
Cross Timbers Hospice [20098] $8 103%
Dept Of Veteran Affairs Contracted [320106] $8 103%
Elara Caring Aspire Hospice Contracted [320433] $8 103%
Elara Caring Aspire Hospice [20433] $8 103%
Globalhealth Contracted [320145] $8 103%
Halo Hcr Inc Hospice Contracted [320432] $8 103%
Halo Hcr Inc Hospice [20432] $8 103%
Independent Health [20197] $8 103%
Indian Health Service Contracted [320198] $8 103%
Kindful Hospice Contracted [320434] $8 103%
Kindful Hospice [20434] $8 103%
Medical Associates Health [20444] $8 103%
Medicare (plans) $8 - $27 103%
Mercy Hospice Okc [20252] $8 103%
Provider Partners Health Plans Contracted [320450] $8 103%
Qual Choice Contracted [320325] $8 103%
Tricare $8 103%
UnitedHealthcare $8 - $10 103%
Ambetter / Centene $10 129%
Health Choice Contracted [320166] $10 129%
Home State Health Plan Contracted [320187] $10 129%
Medica Contracted [320239] $10 - $27 129%
Novasys Contracted [320285] $10 129%
United Medical Resources Contracted [320454] $10 - $16 129%
Healthcare Highways Plus Contracted [320175] $11 - $20 142%
Webtpa Contracted [320417] $11 142%
Osma Health Contracted [320292] $12 154%
Benefit Management Contracted [320052] $14 - $18 180%
Aither Health Contracted [320449] $16 206%
Auxiant Contracted [320462] $16 206%
Ebms Contracted [320493] $16 206%
Federal Medical Center Contracted [320127] $16 206%
Healthlink Contracted [320179] $16 206%
Healthscope Contracted [320182] $16 206%
Imagine 360 Contracted [320494] $16 206%
Mercy Benefit Admin Contracted [320251] $16 - $18 206%
Point C Contracted [320238] $16 206%
Preferred Health Plan Contracted [320522] $16 206%
Quik Trip Contracted [320447] $16 206%
Reflect Health Contracted [320492] $16 206%
Show-Me Health Administrators Contracted [320483] $16 206%
Yuzu Health Contracted [320521] $16 206%
Globalhealth Contracted [320144] $17 219%
Healthsmart Preferred Care Contracted [320184] $17 219%
Kempton Contracted [320214] $17 219%
Workers Comp [20426] $18 232%
First Health Contracted [320128] $22 283%
Multiplan Contracted [320270] $23 296%
Private Health Care Systems Contracted [320320] $23 296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals