CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $121
Cash Discount Price: $131
vs. Medicare Baseline: 15.57x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Texas Childrens Hospital North Austin Campus is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 15.57x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $131 (1686%)

Insurance Median: $121 (1557%)

Cash: $131 (1686% of Medicare)

Ins. Median: $121 (1557% 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 1557% of the Medicare baseline (a markup of 1457%). 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
Superior Chip	$8	103%
Driscoll Children'S Health Plan Mcd	$9	116%
Community Health Choice	$14 - $136	180%
First Care Health Plan	$48 - $136	618%
UnitedHealthcare	$48 - $136	618%
Molina Mcd	$54 - $64	695%
Blue Cross Blue Shield	$63 - $134	811%
Community First Health Plan Mcd	$72 - $85	927%
Cook Children'S Health Plan	$72 - $85	927%
Cigna	$102 - $136	1313%
Aetna	$115 - $136	1480%
Kelseycare	$116 - $138	1493%
Healthsmart	$125 - $148	1609%
Evolutions Healthcare	$134 - $159	1725%
First Health	$158 - $201	2033%
Multiplan	$161 - $191	2072%
Galaxy Health Network	$170 - $201	2188%

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 $131.
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 Texas Childrens Hospital North Austin Campus 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.