CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: St Mary Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $14
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at St Mary Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.80x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$338

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $338 (4350%)
Insurance Median: $14 (180%)
Cash: $338 (4350% of Medicare)
Ins. Median: $14 (180% 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 $7 - $14 90%
Aetna $8 - $152 103%
Align Senior Care $8 103%
Blue Cross Blue Shield $8 - $96 103%
Cigna $8 - $41 103%
Medicare (plans) $8 - $14 103%
Health America Advantra $9 116%
UnitedHealthcare $10 - $54 129%
Pace-Trinity Health $11 142%
Ambetter / Centene $14 180%
Jefferson Health Plan Commercial $14 180%
Keystone First $14 180%
Keystone First Chip $14 180%
Oscar $14 180%
Prime Healthcare $14 180%
Homestead Health Plans Woods Center $15 193%
Group Pension Administrators $17 219%
Reedman Toll $17 219%
Blue Shield - Pa (Highmark) $21 270%
Amerihealth $37 476%
Blue Shield - Ca $37 476%
Blue Shield - Id (Regence) $37 476%
Blue Shield - Ny Highmark Western $37 476%
Blue Shield - Wa (Regence) $37 476%
Upmc Health Plan $41 528%
Webtpa $41 528%
Geha $45 579%
Meritain $99 1274%
Multiplan $100 1287%
Prime Health Services $100 1287%
Galaxy Health Network $105 1351%
Three Rivers Provider Network $105 1351%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals