CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Prosser Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $134
Cash Discount Price: $92
vs. Medicare Baseline: 17.25x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Prosser Memorial Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 17.25x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $92 (1184%)

Insurance Median: $134 (1725%)

Cash: $92 (1184% of Medicare)

Ins. Median: $134 (1725% 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 1725% of the Medicare baseline (a markup of 1625%). 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
UnitedHealthcare	$13 - $68	167%
Kaiser Permanente	$34 - $153	438%
Community Health Plan Of Washington	$36 - $68	463%
Coordinated Care	$36 - $68	463%
Amerigroup	$38 - $72	489%
Molina	$38 - $68	489%
Health Alliance Northwest	$42	541%
Humana	$42 - $143	541%
Wellcare	$42	541%
Aetna	$50 - $143	644%
Ambetter / Centene	$118 - $129	1519%
Asuris	$134 - $151	1725%
Health Management Adminstrators	$134 - $151	1725%
Premera	$134	1725%
Regence	$134 - $151	1725%
Cigna	$138	1776%
First Choice	$143	1840%
Multiplan	$143 - $151	1840%

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 $92.
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 Prosser 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.