CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Northeast Regional Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $103
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 13.26x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Northeast Regional Medical Center is $103. 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 13.26x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $103 (1326%)
Cash: $114 (1467% of Medicare)
Ins. Median: $103 (1326% 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 1326% of the Medicare baseline (a markup of 1226%). 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
Medicaid / KanCare $7 - $11 90%
Node Champva $7 90%
Tricare $7 90%
Node VA $8 103%
Blue Access $8 103%
Node Devoted Health McR Adv $8 103%
Blue Pathway/Pathway X $8 103%
Veterans Eval Services $8 103%
Blue Cross Blue Shield $8 - $88 103%
Node Hospice Non Par Agree $8 103%
Blue Prefrerred $8 103%
Medicare (plans) $8 103%
UnitedHealthcare $8 - $217 103%
Centurion Correctional $10 129%
Us Department of Labor $10 129%
Home State Exchange $14 180%
Naphcare $15 193%
Immergrun $16 206%
Self Pay $69 - $159 888%
Cigna $98 - $113 1261%
Aetna $108 - $241 1390%
Access Health Services, LLC $188 2420%
Multiplan $217 - $231 2793%
Healthlink $217 - $231 2793%
Coventry Wc $231 2973%

Consumer Guidance & Cost Commentary

For a complete blood count (CBC) procedure at Northeast Regional Medical Center in Kirksville, MO, the cash median rate is $114, which is notably lower than the facility's gross charge of $289. This service is rated 2 stars by CMS, and while the facility is a Proprietary Acute Care Hospital, patients should note that the cash price of $114 may be more affordable than the median negotiated rate of $103 for many commercial payers, particularly those with high deductibles where the insurance allowed amount could exceed the cash price. The data reflects pricing for CPT code 85025 as of the 2026-06 vintage, with 25 distinct payers listed, including UnitedHealthcare and Aetna, which have significantly higher negotiated ranges.

To minimize costs, patients should request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected via a formal written dispute. While the facility offers a cash median of $114, the self-pay price range spans from $69 to $159 across different plan types, so patients must explicitly ask for "prompt-pay" discounts and sign a waiver of insurance submission to ensure the agreed cash rate applies. It is critical to avoid accepting summary bills that obscure individual line items, and instead demand a full CPT-coded statement to identify any charges for services not rendered or unbundled components before paying the balance.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 S Osteopathy, Kirksville, MO 63501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals