CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Nacogdoches Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $37
Cash Discount Price: $19
vs. Medicare Baseline: 4.76x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Nacogdoches Memorial Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 4.76x the Medicare baseline. Located in 1204 Mound St, Nacogdoches, TX.

Cash / Self-Pay

$19

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $19 (245%)

Insurance Median: $37 (476%)

Cash: $19 (245% of Medicare)

Ins. Median: $37 (476% 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 476% of the Medicare baseline (a markup of 376%). 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
Hiet Benefit Plan	$5 - $132	64%
UnitedHealthcare	$5 - $48	64%
Blue Cross Blue Shield	$7 - $106	90%
Galaxy	$8 - $86	103%
Healthspring	$8	103%
Humana	$8	103%
Molina	$8 - $132	103%
Wellmed	$8 - $132	103%
Aetna	$10 - $106	129%
Healthsmart	$10 - $106	129%
Phcs	$10 - $106	129%
Usa Health Network	$10 - $99	129%

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 $19.
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 Nacogdoches Memorial Hospital 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.