CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Carilion Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $91
Cash Discount Price: $51
vs. Medicare Baseline: 11.71x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Carilion Medical Center is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 11.71x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $51 (656%)

Insurance Median: $91 (1171%)

Cash: $51 (656% of Medicare)

Ins. Median: $91 (1171% 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 1171% of the Medicare baseline (a markup of 1071%). 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
Blue Cross Blue Shield	$8	103%
Sentara Health Plan	$8 - $91	103%
Abh Of Va (Formerly Coventry)	$9	116%
Abh Of Wva (Formerly Coventry)	$9	116%
Humana	$9	116%
UnitedHealthcare	$9 - $119	116%
Aetna	$74 - $97	952%
Gateway - Tier 3	$80	1030%
Vhn - Ultra	$91	1171%
Cigna	$98 - $105	1261%
Connecticare	$102	1313%
Vhn - Plus	$112	1441%
Gateway - Tier 2	$117	1506%
Vhn	$117	1506%
Vhn - Link	$131	1686%
Gateway - Tier 1	$139	1789%
Vhn - Secondary Payors	$139	1789%

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 $51.
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 Carilion Medical Center 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.