CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $79
Cash Discount Price: $130
vs. Medicare Baseline: 10.17x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 10.17x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $130 (1673%)

Insurance Median: $79 (1017%)

Cash: $130 (1673% of Medicare)

Ins. Median: $79 (1017% 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 1017% of the Medicare baseline (a markup of 917%). 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 - $41	103%
Group Health Cooperative Of Eau Claire	$8 - $130	103%
Humana	$8 - $122	103%
Icare	$8 - $9	103%
Managed Health Services	$8	103%
Molina Healthcare Of Wi	$8 - $116	103%
My Choice	$8	103%
Network Health Plan	$8 - $114	103%
Quartz	$8 - $78	103%
Security Health Plan (Shp)	$8 - $79	103%
Trilogy	$8 - $123	103%
UnitedHealthcare	$8 - $27	103%
Veteran'S Administration (Va Ccn)	$8	103%
The Alliance	$70	901%
Amish/Mennonite	$75	965%
Wps Health Insurance	$92	1184%
Cigna	$93 - $101	1197%
Health Payment Systems	$95	1223%
First Health	$116	1493%
Healtheos By Multiplan Inc.	$127 - $130	1634%
Health Partners	$130	1673%
Coventry	$132	1699%

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 $130.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.