CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: UPMC Muncy

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $82
Cash Discount Price: $95
vs. Medicare Baseline: 10.55x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at UPMC Muncy is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 10.55x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $95 (1223%)

Insurance Median: $82 (1055%)

Cash: $95 (1223% of Medicare)

Ins. Median: $82 (1055% 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 1055% of the Medicare baseline (a markup of 955%). 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
Amerihealth Caritas	$7 - $2,208	90%
Geisinger	$7 - $107	90%
Highmark Wholecare (Prev Gateway)	$7 - $24	90%
Upmc Health Plan	$7 - $69	90%
Three Rivers Provider Network	$8 - $143	103%
UnitedHealthcare	$8 - $109	103%
Upmc Work Partners	$8	103%
Pa Health & Wellness	$10 - $2,316	129%
Cigna	$25 - $109	322%
Aetna	$49 - $105	631%
Coventry/First Health	$60 - $107	772%
Blue Cross Blue Shield	$62 - $73	798%
Wirerope Works	$88	1133%
Multiplan	$124 - $151	1596%
America'S Choice	$127	1634%
Intergroup	$127	1634%

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 $95.
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 UPMC Muncy 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.