CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $60
  • Cash Discount Price: $273
  • vs. Medicare Baseline: 7.72x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Hospital of Univ of Pennsylvania is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.72x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$273

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $273 (3514%)
Insurance Median: $60 (772%)
Cash: $273 (3514% of Medicare)
Ins. Median: $60 (772% 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 772% of the Medicare baseline (a markup of 672%). 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
Gspp And Wissahickon Hospice $4 51%
Cigna $5 - $123 64%
Kaiser Permanente $6 - $273 77%
Medicaid / KanCare $6 - $273 77%
Pa Medical Assistance $6 - $273 77%
UnitedHealthcare $7 - $273 90%
Aetna $8 - $273 103%
Blue Cross Blue Shield $8 - $189 103%
Clover Health Plan $8 103%
Devoted Health $8 103%
Geisinger Health Plan $8 - $25 103%
Health Partners $8 - $273 103%
Humana $8 - $218 103%
Ibc $8 103%
Keystone Mercy Health Plan $8 - $273 103%
Medicare (plans) $8 103%
Pa Health And Wellness $8 - $13 103%
Penn Life (Living Independently For Elders) $8 103%
Philadelphia Va Medical Center $8 103%
Tricare $8 103%
Upmc $8 - $273 103%
Us Family Health Plan $8 103%
Keystone First $9 116%
Gateway Health Plan $10 129%
Elap $11 142%
Claims Watcher $12 - $14 154%
Ibc Commercial Hpn $12 154%
Keystone Hmo Proactive $13 167%
Oscar Health Plan $13 167%
Centivo $14 180%
Elap Services $14 180%
Highmark $16 206%
Penn Global Medicine $21 270%
Paired Kidney Exchange $22 283%
Horizon Nj Health $46 - $48 592%
Preferred Health Care Eliance $60 772%
Pgm - Regie De L'Assurance Maladie Quebec $63 811%
Pgm - Kuwait Defense $96 - $123 1236%
Qualcare $104 1338%
Olympus $107 1377%
Coventry $109 - $139 1403%
Pgm - Chop $109 1403%
Wissahickon Hospice $109 1403%
Healthamerica/Coventry $123 - $134 1583%
First Health Global $136 1750%
Health Net $164 2111%
Pgm - Royal Embassy Of Saudi Arabia $164 2111%
Pgm - Embassy Of Qatar $177 2278%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $177 2278%
Interlink $183 2355%
Pgm - Embassy Of The United Emirates/Ipc $191 2458%
Health America/Ccn $218 2806%
Intergroup $218 2806%
Pgm - Kuwait Health Division $218 2806%
Pgm - Kuwait Oil $218 2806%
Preferred Care $218 2806%
Blue Quality Centers For Transplant (Bqct) $273 3514%
City Of Philadelphia Behavioral Health $273 3514%
Commercial Other $273 3514%
International Pfs $273 3514%
United Behavioral Health $273 3514%
Workers Compensation $273 3514%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals