CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: The Heart Hospital Baylor Denton

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $34
Cash Discount Price: $102
vs. Medicare Baseline: 4.38x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at The Heart Hospital Baylor Denton is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 4.38x the Medicare baseline. Located in 2801 South Mayhill Road, Denton, TX.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $102 (1313%)

Insurance Median: $34 (438%)

Cash: $102 (1313% of Medicare)

Ins. Median: $34 (438% 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 438% of the Medicare baseline (a markup of 338%). 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
Baylor Scott & White Health Plan	$7 - $99	90%
American Health Plan	$8	103%
Blue Cross Blue Shield	$8 - $38	103%
Corvel	$8	103%
Healthspring	$8	103%
Humana	$8 - $119	103%
Prime Health Services	$8	103%
Procare Advantage	$8	103%
Superior Health Plan	$8 - $19	103%
Triwest	$8	103%
UnitedHealthcare	$9 - $11	116%
Ambetter / Centene	$16	206%
Cigna	$84 - $99	1081%
Aetna	$94	1210%
Employers Health Network	$94	1210%
Quiktrip	$94	1210%
University Of Mary Hardin-Baylor	$99	1274%
Imagine Health	$107	1377%
Curative	$111	1429%
First Health	$119	1532%
Healthsmart	$119 - $128	1532%
Private Health Care System	$128	1647%

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 $102.
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 The Heart Hospital Baylor Denton 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.