CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Hospital Metropolitano Dr Pila

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $9
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Hospital Metropolitano Dr Pila is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.16x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $42 (541%)
Insurance Median: $9 (116%)
Cash: $42 (541% of Medicare)
Ins. Median: $9 (116% 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
First Medical $7 - $9 90%
Mso $7 - $8 90%
Privado $7 90%
Aarp $8 103%
Plan De Salud Menonita $8 103%
Tricare $8 103%
Triple S $8 - $10 103%
Auxilio Mutuo $9 116%
Bl $9 116%
Humana $9 - $11 116%
Mc $9 116%
Mcs $9 - $11 116%
Medicare (plans) $9 116%
Cigna $10 129%
Fondo Del Seguro Estado $10 129%
Prossam $10 129%
Ch $11 142%
Comerciales $11 142%
Hospicio $11 142%
Life Link $11 142%
Mapfre $11 142%
Salud Correccional $11 142%
Va $11 142%
Wellcare $11 142%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2435 Boulevard Luis A Ferre, Ponce, PR 00717
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals