CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Charleston Area Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $155
Cash Discount Price: $189
vs. Medicare Baseline: 19.95x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Charleston Area Medical Center is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 19.95x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$189

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $189 (2432%)

Insurance Median: $155 (1995%)

Cash: $189 (2432% of Medicare)

Ins. Median: $155 (1995% 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 1995% of the Medicare baseline (a markup of 1895%). 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
Aetna	$7 - $200	90%
The Health Plan Of West Virginia Inc.	$7 - $198	90%
Unicare Health Plan Of West Virginia Inc.	$7	90%
Blue Cross Blue Shield	$8 - $186	103%
Choicecare Network	$8 - $200	103%
Optimum Choice Inc.	$8	103%
Triwest Va	$8	103%
UnitedHealthcare	$8 - $200	103%
West Virginia Senior Advantage Inc.	$8	103%
Integrated Medical Solutions	$15	193%
Naphcare	$16	206%
Caresource	$19	245%
Tricare	$104 - $122	1338%
City Of Charleston	$130 - $153	1673%
Cigna	$161 - $190	2072%
Three Rivers Providers Network	$168 - $198	2162%
Healthsmart	$170 - $200	2188%
Multiplan	$170 - $200	2188%

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 $189.
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 Charleston Area Medical Center 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.