CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Unitypoint Health - Meriter

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $43
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 5.53x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Unitypoint Health - Meriter is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 5.53x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $119 (1532%)
Insurance Median: $43 (553%)
Cash: $119 (1532% of Medicare)
Ins. Median: $43 (553% 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 553% of the Medicare baseline (a markup of 453%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $5 - $62 64%
Aspirus $8 - $89 103%
Blue Cross Blue Shield $8 - $142 103%
Humana $8 103%
Illinicare $8 103%
Meridiancare $8 103%
Prevea 360 $8 - $127 103%
Wellmark Uph Self-Funded $8 - $86 103%
Health Partners Open Network $12 - $54 154%
Cigna $33 - $45 425%
Security Health Plan $35 - $46 450%
Mercy Care $41 - $50 528%
Medical Associates Health Plan $43 - $54 553%
Quartz $47 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals