CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Astria Sunnyside Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $127
Cash Discount Price: $106
vs. Medicare Baseline: 16.34x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Astria Sunnyside Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 16.34x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $106 (1364%)

Insurance Median: $127 (1634%)

Cash: $106 (1364% of Medicare)

Ins. Median: $127 (1634% 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 1634% of the Medicare baseline (a markup of 1534%). 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
Medicare (plans)	$7 - $8	90%
Aetna	$8 - $183	103%
Healthcomp_Ihs	$8	103%
Humana	$8 - $187	103%
Tricare	$8	103%
Va	$8	103%
Medicaid / KanCare	$40 - $64	515%
Molina	$40 - $51	515%
Regence	$84 - $107	1081%
Cigna	$98 - $125	1261%
Li	$100 - $128	1287%
First_Choice	$122 - $156	1570%
Tpsc	$127 - $162	1634%
Kaiser	$128 - $163	1647%
Premera	$133 - $169	1712%
UnitedHealthcare	$139 - $177	1789%
Fhpw	$143 - $183	1840%
Healthcomp	$147 - $187	1892%
Bcchp	$163 - $208	2098%
Great_Rivers	$163 - $208	2098%
Zenith	$163 - $208	2098%

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 $106.
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 Astria Sunnyside 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.