CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Childrens Hospital of Wisconsin

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $126
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 16.22x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Childrens Hospital of Wisconsin is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 16.22x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $87 (1120%)
Insurance Median: $126 (1622%)
Cash: $87 (1120% of Medicare)
Ins. Median: $126 (1622% 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 1622% of the Medicare baseline (a markup of 1522%). 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
Chorus Community Health Plan $8 103%
Managed Health Services $8 103%
My Choice Wisconsin $8 - $9 103%
UnitedHealthcare $8 - $120 103%
Blue Cross Blue Shield $9 - $150 116%
Molina Healthcare Of Wisconsin $9 116%
Icare $10 129%
Froedtert Health $110 - $134 1416%
Medical College Of Wisconsin $110 1416%
Network Health Plan $112 1441%
Aspirus Health Plan $118 1519%
Common Ground Healthcare Cooperative $118 - $134 1519%
Trilogy Health Solutions $118 - $134 1519%
Wps Health Plan $120 - $142 1544%
Advocate Aurora Healthcare $121 1557%
Centivo $123 1583%
Health Partners $123 - $139 1583%
Employer Health Care Alliance Cooperative $124 1596%
Dean Health Plan $126 1622%
Group Health Cooperative Of Eau Claire $126 1622%
Oan Llc $126 1622%
Security Health Plan $131 1686%
Health Payment Systems $133 1712%
Praire States $134 1725%
Quartz Health Insurance $134 1725%
Sheboygan Employer'S Health Network $134 1725%
Mayo Clinic Health Solutions $137 1763%
Aetna $139 - $140 1789%
Bellin Thedacare $142 1828%
Cigna $142 1828%
Group Health Cooperative Of South Central Wisconsin $142 1828%
Prevea Health Network $142 1828%
Multiplan $144 - $150 1853%
Coventry Health Care $150 1931%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens