CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Monument Health Rapid City Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $103
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 13.26x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Monument Health Rapid City Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 13.26x the Medicare baseline. Located in 353 Fairmont Blvd, Rapid City, SD.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $129 (1660%)
Insurance Median: $103 (1326%)
Cash: $129 (1660% of Medicare)
Ins. Median: $103 (1326% 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 1326% of the Medicare baseline (a markup of 1226%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Humana $8 - $116 103%
Medicare (plans) $8 103%
UnitedHealthcare $8 - $85 103%
Va Black Hills Health Care System 12115 [3081206] $8 103%
Health Partners Sx009 [3081102] $12 - $80 154%
Healthpartners [3081368] $12 154%
Risk Admin Svs [3081167] $30 - $103 386%
Tricare $36 463%
Blue Cross Blue Shield $37 476%
Minnesota Health Care Programs 12K16 [3081295] $39 502%
Coresource 38225 [3081146] $84 - $88 1081%
Govt Employees Health Assn [3081090] $85 1094%
National Telephone Cooperative Assn 52103 [3081149] $85 1094%
Surest [3081369] $85 1094%
United Medical Resources 39026 [3081194] $85 1094%
Avera Health Plans 46045 [3081018] $95 1223%
Rocky Mountain Admin Llc 83028 [3081168] $103 1326%
Medica (Commercial) 94265 [3081118] $107 1377%
Employee Benefit Management 12X44 [3081079] $110 1416%
Pacificsource Health Plans [3081333] $110 1416%
Tlc Advantage Llc [3081189] $112 - $121 1441%
Aetna $116 1493%
Group And Pension Administrators Inc [3081098] $116 1493%
Multiplan Inc 34080 [3081285] $116 1493%
Sanford Health Plan 91184 [3081174] $116 1493%
Fedmed Inc [3081283] $123 1583%
Allied Benefit Systems Inc [3081320] $124 1596%
Cigna $124 1596%
Key Benefit Administrators [3081332] $124 1596%
Meritain Health [3081135] $124 1596%
Midlands Choice 47080 [3081136] $124 1596%
Preferred One 41147 [3081160] $124 1596%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 353 Fairmont Blvd, Rapid City, SD 57701
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals