CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Kenmore Mercy Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $7
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Kenmore Mercy Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 0.90x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $20 (257%)
Insurance Median: $7 (90%)
Cash: $20 (257% of Medicare)
Ins. Median: $7 (90% 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.

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
Excellus Rochester McD [350117] $3 39%
Medicaid / KanCare $3 - $8 39%
Univera Healthcare Essential [100170] $3 - $7 39%
Molina Essential [100167] $3 - $7 39%
Tuscarora Nation [550120] $3 39%
Beacon Essential [350122] $3 39%
Independent Health Essential [100166] $3 - $7 39%
Crime Victims [100176] $3 39%
VA Veterans Affairs [700001] $3 - $8 39%
UnitedHealthcare $3 - $8 39%
Vna Option Mltc [350110] $3 39%
Blue Cross Blue Shield $4 - $15 51%
Medicare (plans) $6 - $8 77%
Independent Health [100165] $6 - $8 77%
Iha First Choice [800001] $6 - $7 77%
Univera Healthcare [100169] $7 - $12 90%
Fidelis Essential [100163] $7 - $9 90%
Wellcare [450129] $8 - $9 103%
Humana $8 103%
Fallon Health [450115] $8 103%
Catholic Health Life Pace [400005] $8 103%
Seneca Nation [450119] $8 103%
Cigna $8 103%
Fidelis Dual Advantage [450120] $8 103%
Tricare $8 103%
Aetna $8 103%
Wellcare Fidelis Dual [450451] $8 103%
Covid19 Hrsa [45013] $8 103%
Champ VA [700002] $8 103%
Federal Workers Compensation [500100] $8 - $12 103%
Hospice [550001] $8 103%
Fidelis Exchange [100164] $9 - $12 116%
No Fault [114001] $12 154%
Amerigroup [350102] $15 193%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2950 Elmwood Avenue, Kenmore, NY 14217
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals