CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Othello Community Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $111
Cash Discount Price: $104
vs. Medicare Baseline: 14.29x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Othello Community Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 14.29x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.

Cash / Self-Pay

$104

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $104 (1338%)

Insurance Median: $111 (1429%)

Cash: $104 (1338% of Medicare)

Ins. Median: $111 (1429% 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 1429% of the Medicare baseline (a markup of 1329%). 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
Ambetter / Centene	$59 - $60	759%
Amerigroup Mcaid	$59	759%
Chp Mcaid	$59	759%
Cocare - All Plans	$59	759%
Gau - All Plans	$59	759%
Kaiser - All Plans	$59	759%
Molina Mcaid	$59	759%
UnitedHealthcare	$59 - $139	759%
Chp - All Other Plans	$60	772%
Molina - All Other Plans	$60	772%
Medicare (plans)	$69	888%
Tricare	$90	1158%
Triwest - All Plans	$90	1158%
Asuris - All Plans	$111	1429%
Commercial Other - All Plans	$111	1429%
Hma - All Plans	$111	1429%
Hmso - All Plans	$111	1429%
Tpsc - All Plans	$111	1429%
Travelers - All Plans	$111	1429%
Veterans Admin - All Plans	$111	1429%
Blue Cross Blue Shield	$117	1506%
Cigna	$123	1583%
First Choice - All Plans	$125	1609%
Aetna	$130	1673%
Chp Mcr Adv	$139	1789%
Health Alliance Mcr Adv - All Plans	$139	1789%
Humana	$139	1789%
Molina Mcare	$139	1789%
Wellcare Mcr Adv - All Plans	$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 $104.
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 Othello Community 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.