Blood test, complete blood count (CBC)
Facility: Oakleaf Surgical Hospital
Billing Code: 85025 (CPT)
- CPT Billing Code: 85025
- Insurance Median: $8
- Cash Discount Price: $75
- vs. Medicare Baseline: 1.03x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | 103% |
| Dean Health Plan | $8 | 103% |
| Group Health Cooperative Of Eau Claire | $8 | 103% |
| Healthpartners | $8 | 103% |
| Humana | $8 | 103% |
| Medica | $8 | 103% |
| Quartz Health Solutions | $8 | 103% |
| Security Health Plan Of Wi | $8 | 103% |
| Ucare Wi | $8 | 103% |
| UnitedHealthcare | $8 | 103% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Oakleaf Surgical Hospital in Altoona, Wisconsin, the most significant pricing benchmark is the gross charge of $84, which represents the full list price before any discounts. This amount is notably higher than the state average cash rate of $75, indicating that the facility's published charges exceed the typical cost for this service in Wisconsin. While the facility's ownership is physician-owned, the lack of a facility rating in the data suggests that patient experience metrics were not reported for this specific transaction.
Insurance coverage for this service varies significantly by payer, with all ten listed plans in the dataset negotiating a uniform rate of $8 per plan. This negotiated amount is substantially lower than the facility's gross charge and the state's median negotiated rate of $8, though it is higher than the actual median paid amount of $66, which appears to reflect a specific case scenario or data anomaly rather than a general trend. Patients should be aware that cash-pay options often result in lower costs than insurance claims, especially for high-deductible plans where the insurance allowed amount might exceed the cash price. To secure the best possible rate, individuals are encouraged to inquire directly with the hospital about self-pay or prompt-pay discounts before scheduling the test.