CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Upland Hills Health

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $59
Cash Discount Price: $114
vs. Medicare Baseline: 7.59x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Upland Hills Health is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.59x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $114 (1467%)

Insurance Median: $59 (759%)

Cash: $114 (1467% of Medicare)

Ins. Median: $59 (759% 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 759% of the Medicare baseline (a markup of 659%). 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
UnitedHealthcare	$3 - $7	39%
Blue Cross Blue Shield	$6 - $59	77%
Ghc Of Eau Claire	$6	77%
Ghc Of Sc Wi	$6 - $143	77%
Mhs	$6 - $59	77%
Dean Health Plan	$51	656%
Humana	$59 - $190	759%
Icare	$59	759%
Medical Associates	$59 - $158	759%
Security Health Plan	$59	759%
Quartz	$77	991%
Alliance	$119	1532%
Wps	$129 - $133	1660%
Cigna	$157 - $176	2021%
Multiplan	$186	2394%

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 $114.
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 Upland Hills Health 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.