CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Pawhuska Hospital, Inc

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $32
Cash Discount Price: $24
vs. Medicare Baseline: 4.12x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Pawhuska Hospital, Inc is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 4.12x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $24 (309%)

Insurance Median: $32 (412%)

Cash: $24 (309% of Medicare)

Ins. Median: $32 (412% 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 412% of the Medicare baseline (a markup of 312%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$3 - $31	39%
Healthchoice Ip/Op Only - All Plans	$13	167%
Community Care Comm - All Plans	$19	245%
Blue Cross Blue Shield	$20 - $37	257%
Aetna	$23 - $43	296%
Humana	$23 - $43	296%
Tricare	$23 - $25	296%
Wellcare Mcr Adv - All Plans	$23 - $25	296%
Healthcare Highways - All Plans	$25 - $28	322%
Cigna	$26 - $29	335%
Multiplan - All Plans	$29 - $32	373%
Ambetter / Centene	$34 - $37	438%
Preferred Commchoice Ip/Op Only - All Plans	$35 - $39	450%
Soonerselect Mcaid - All Plans	$39 - $43	502%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $24.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pawhuska Hospital, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85025.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.