CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: UPMC Wellsboro

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $96
Cash Discount Price: $105
vs. Medicare Baseline: 12.36x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at UPMC Wellsboro is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 12.36x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $105 (1351%)

Insurance Median: $96 (1236%)

Cash: $105 (1351% of Medicare)

Ins. Median: $96 (1236% 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 1236% of the Medicare baseline (a markup of 1136%). 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	$6	77%
Geisinger	$7 - $107	90%
Highmark Wholecare (Prev Gateway)	$7 - $32	90%
Upmc Health Plan	$7 - $69	90%
UnitedHealthcare	$8 - $135	103%
Upmc Work Partners	$8	103%
Health Partners Plans (Jefferson Health Plan)	$9	116%
Pa Health & Wellness	$10 - $34	129%
Aetna	$26 - $137	335%
Blue Cross Blue Shield	$29 - $80	373%
Cigna	$30 - $33	386%
Wirerope Works	$80 - $88	1030%
Multiplan	$112 - $151	1441%
America'S Choice	$130 - $143	1673%
Intergroup	$130 - $143	1673%

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 $105.
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 Wellsboro 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.