CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Children's Hospital of Philadelphia

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $177
Cash Discount Price: $404
vs. Medicare Baseline: 22.78x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Children's Hospital of Philadelphia is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 22.78x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$404

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $404 (5199%)

Insurance Median: $177 (2278%)

Cash: $404 (5199% of Medicare)

Ins. Median: $177 (2278% 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 2278% of the Medicare baseline (a markup of 2178%). 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
Geisinger Medical Assistance	$8	103%
Highmark Wholecare	$9	116%
Horizon Nj Health	$18	232%
Medicaid / KanCare	$58 - $75	746%
UnitedHealthcare	$59 - $250	759%
Health Partners	$67 - $86	862%
Aetna	$83 - $227	1068%
Upmc Medical Assistance	$96 - $124	1236%
Keystone First Chip	$110 - $141	1416%
Keystone Health Plan East	$112 - $144	1441%
Blue Cross Blue Shield	$125 - $182	1609%
Geisinger Health Plan Commercial	$155 - $200	1995%
Jefferson Health Plans	$167 - $215	2149%
Cigna	$177 - $227	2278%
Highmark	$177 - $227	2278%
Qualcare	$194 - $250	2497%
First Health Network	$230 - $295	2960%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$283 - $363	3642%
Private Health Care Systems	$283 - $363	3642%
Choice Care Network	$318 - $409	4093%

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 $404.
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 Children's Hospital of Philadelphia 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.