CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Prisma Health Hillcrest Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $10
  • Cash Discount Price: $82
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Prisma Health Hillcrest Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.29x the Medicare baseline. Located in 741 South East Main Street, Simpsonville, SC.
Cash / Self-Pay
$82

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $82 (1055%)
Insurance Median: $10 (129%)
Cash: $82 (1055% of Medicare)
Ins. Median: $10 (129% 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
Tricare $6 77%
Golden Rule Insurance Company [2991] $7 90%
Oxford Health Plans [2992] $7 90%
UnitedHealthcare $7 - $10 90%
Zzumr-Salt Lake City Ut [3169] $7 90%
Aetna $8 - $100 103%
Blue Cross Blue Shield $8 - $67 103%
Champva [3049] $8 103%
Cigna $8 - $44 103%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $8 103%
Deseret Mutual Ins Co [3066] $8 103%
Generic Skilled Nursing [3196] $8 103%
Healthy Conn Prime-First Choice Vip Care [5300] $8 103%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $8 103%
Hospice Contracted [1500] $8 103%
Hospice Non Contracted [3190] $8 103%
Humana $8 - $10 103%
Medicare (plans) $8 - $10 103%
Triwest Healthcare Alliance Vcp [902] $8 103%
Va Community Care Network-Vaccn [903] $8 103%
Veterans Administration [3194] $8 103%
Healthy Conn Prime-Molina Healthcare [5330] $9 116%
First Choice Benefits Mgmt [3074] $10 129%
Medicaid / KanCare $10 129%
Workers Comp [600] $11 142%
Ambetter / Centene $14 180%
Sc Dept Of Corrections [2998] $27 347%
Scdc-Sc Dept Of Corrections [7232] $27 347%
Prisma Health Seniorcare Pace - Midlands [5400] $29 373%
Prisma Health Seniorcare Pace-Upstate [5200] $29 373%
Bluechoice [810] $43 - $70 553%
Evernorth Behavioral Contracted [2982] $44 566%
Mvp Health Care [3037] $44 566%
Promise Health Plan Contracted [2401] $44 - $76 566%
Orangeburg Senior Helping Center Pace [5401] $50 644%
Planned Administrators [820] $67 862%
Bob Jones Univ-Pai [821] $76 978%
Meritain Health Contracted [2200] $81 - $100 1042%
Preferred Administrators Contracted [2839] $88 1133%
Medcost [2940] $93 - $105 1197%
Atlantic Packaging Contracted [4833] $94 1210%
Aps Healthcare System [2981] $101 1300%
Multiplan/Phcs Contracted [2950] $112 1441%
Vsp Vision Care [2986] $113 1454%
First Health Contracted [2952] $117 1506%
Furman Int/Allen University Student [2951] $117 1506%
Quiktrip-First Health [3067] $117 1506%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 741 South East Main Street, Simpsonville, SC 29681
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals