CMS Price Transparency Data
Blood test, complete blood count (CBC)
Facility: Watsonville Community Hospital
Billing Code: 85025 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85025
- Insurance Median: $830
- Cash Discount Price: $902
- vs. Medicare Baseline: 106.82x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Watsonville Community Hospital is $830. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $902. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 106.82x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$902
Average discount available for prompt cash payment at this facility.
Insurance Median
$830
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: $902 (11609%)
Insurance Median: $830 (10682%)
Cash: $902 (11609% of Medicare)
Ins. Median: $830 (10682% 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 10682% of the Medicare baseline (a markup of 10582%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Pinnacle Healthcare Uc | $8 | 103% |
| Secure Horizons Dign HMO | $8 - $301 | 103% |
| Blue Shield PPO | $8 - $25 | 103% |
| Health Net of California | $8 - $943 | 103% |
| Fleming & Associates | $8 | 103% |
| Gallagher Bassett Svcs | $8 | 103% |
| Alignment Health Plan | $8 | 103% |
| UnitedHealthcare | $8 - $902 | 103% |
| Crawford & Co | $8 | 103% |
| Miscellaneous Work Comp | $8 | 103% |
| Tricare | $8 | 103% |
| Republic Idemnity W/Comp | $8 | 103% |
| Kemper Group Workers Comp | $8 | 103% |
| Hartford Workers' Comp | $8 | 103% |
| Fireman's Fund Work Comp | $8 | 103% |
| Western Growers Work Comp | $8 | 103% |
| Workers Comp | $8 | 103% |
| Beta Healthcare Group | $8 | 103% |
| Liberty Mutual Work Comp | $8 | 103% |
| Keenan & Assoc Work Comp | $8 | 103% |
| Ace-Usa | $8 | 103% |
| Veterans Administration | $8 | 103% |
| Nx Health Network | $8 | 103% |
| Secure Horizons | $8 | 103% |
| Medicare (plans) | $8 | 103% |
| U.S. Dept. of Labor | $8 | 103% |
| Travelers Insurance | $8 - $1,503 | 103% |
| Great-West/Phcs | $9 - $1,052 | 116% |
| Cigna | $9 - $1,052 | 116% |
| Aetna | $9 - $1,233 | 116% |
| Blue Shield HMO | $9 - $301 | 116% |
| Blue Cross Blue Shield | $9 - $1,339 | 116% |
| Pacificare HMO | $9 - $902 | 116% |
| Health Net Pmg HMO | $9 - $943 | 116% |
| California Childrens Srvs | $10 | 129% |
| Medi-Cal E.R. | $10 | 129% |
| Medicaid / KanCare | $10 | 129% |
| Well Path | $10 - $1,503 | 129% |
| Alliance/Sccho | $10 | 129% |
| Ccs/Monterey County | $10 | 129% |
| Medi-Cal/Eds | $10 | 129% |
| Healthy Families | $10 - $25 | 129% |
| United Agriculture | $25 | 322% |
| Bs Employee | $25 | 322% |
| Ufcw/Valley Clerks | $25 | 322% |
| Pinnacle Claims Tpa/Bc | $52 - $1,339 | 669% |
| State Compensation Fund | $52 - $1,339 | 669% |
| Operating Engineers | $52 - $1,339 | 669% |
| Laborers Health & Welfare | $52 - $1,339 | 669% |
| Carpenters H&W Trust | $52 - $1,339 | 669% |
| Sheet Metal Workers | $52 - $1,339 | 669% |
| Teamsters Benefit Trust | $52 - $1,339 | 669% |
| Delta Health Systems | $52 - $1,339 | 669% |
| Calif Ironworkers Field | $52 - $1,339 | 669% |
| Monterey Bay Pub Emp Trst | $52 - $1,339 | 669% |
| Claims Management Wc | $52 - $1,339 | 669% |
| Western Growers Trust/Bc | $52 - $1,339 | 669% |
| City of Wats/Pinnacle Clm | $52 - $1,339 | 669% |
| Robert Kennedy/Ccn | $52 - $1,339 | 669% |
| Medicruz | $271 | 3488% |
| Victim Compensation Plan | $271 - $1,503 | 3488% |
| Western Health Advantage | $752 | 9678% |
| Pacificare PPO | $902 | 11609% |
| Self Pay | $902 | 11609% |
| Health Net Smartcare Netw | $902 | 11609% |
| Health Net Blue and Gold | $943 | 12136% |
| Health Net Canopycare HMO | $943 | 12136% |
| Adventist Risk Management | $1,052 - $1,203 | 13539% |
| First Health | $1,052 - $1,203 | 13539% |
| Geha (Ccn) | $1,052 - $1,203 | 13539% |
| Transwestern | $1,052 - $1,203 | 13539% |
| Private Healthcare System | $1,173 | 15097% |
| Multiplan Inc PPO | $1,173 | 15097% |
| Coastal Healthcare Admin | $1,278 - $1,353 | 16448% |
| Salinas Valley Mem Hops | $1,278 | 16448% |
| Physicians Mutual | $1,503 | 19344% |
| Prucare Pmg HMO | $1,503 | 19344% |
| North Calif Bakery Driver | $1,503 | 19344% |
| Allstate | $1,503 | 19344% |
| Miscellaneous Insurance | $1,503 | 19344% |
| Apwu Health Plan | $1,503 | 19344% |
| Bankers Life & Casualty | $1,503 | 19344% |
| Humana | $1,503 | 19344% |
| Prucare Pmg POS | $1,503 | 19344% |
| Zenith National Ins | $1,503 | 19344% |
| Wholesale Beer Distributo | $1,503 | 19344% |
| Sutter Health Plus | $1,503 | 19344% |
| Aarp | $1,503 | 19344% |
| Aaa | $1,503 | 19344% |
| United Administrative | $1,503 | 19344% |
| State Farm Ins | $1,503 | 19344% |
| Miscellaneous Auto | $1,503 | 19344% |
| Farmers Insurance | $1,503 | 19344% |