CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Clarion Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $15
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Clarion Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.93x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $27 (347%)
Insurance Median: $15 (193%)
Cash: $27 (347% of Medicare)
Ins. Median: $15 (193% 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.

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
Medicaid / KanCare $6 77%
Amerihealth $7 - $8 90%
Martin'S Point - Usfhp $7 - $17 90%
Tricare $7 90%
Aetna $8 - $43 103%
Cigna $8 - $24 103%
Devoted Health Plan $8 - $19 103%
Gateway $8 - $18 103%
Geisinger $8 - $9 103%
Highmark $8 - $16 103%
Highmark Community Blue $8 103%
Medicare (plans) $8 103%
Pa Health & Wellness $8 103%
The Health Plan $8 - $18 103%
UnitedHealthcare $8 103%
Upmc $8 - $39 103%
American Health Plan $9 116%
Jefferson Health Plan $9 116%
Highmark - Ind.& Managed Care $16 - $17 206%
Peak Health $18 - $34 232%
Devon $36 463%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals