85025

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

Medicare pricing data for 55,526 providers across 52 states

🤖AI Overview

This is one of the most commonly performed procedures in Medicare, with 26.2 million services annually. Even small pricing inefficiencies here affect millions of patients. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count (HCPCS code 85025) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $7.59, but hospitals typically charge $36.17 — a 4.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.52

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $7.59, your out-of-pocket cost would be approximately $1.52. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$7.59
Average Hospital Charge
$36.17
Markup Ratio
4.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$36.17
Medicare Allowed$7.59
Medicare Payment$7.59

Hospitals charge 4.8x more than what Medicare allows for this procedure. Medicare actually pays $7.59 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$8$22179,404+0.1%
Florida$8$352,7062,933,678+0.1%
Kansas$8$43525538,899+0.1%
Maryland$8$35795553,853+0.1%
Massachusetts$8$401,384474,067+0.1%
New Hampshire$8$281789,700+0.1%
New Jersey$8$381,2342,374,092+0.1%
New Mexico$8$4014883,111+0.1%
New York$8$563,2431,345,475+0.1%
North Carolina$8$313,1841,881,855+0.1%
Pennsylvania$8$36615466,436+0.1%
Rhode Island$8$323034,779+0.1%
Arizona$8$30907927,616+0.1%
California$8$372,1972,745,664+0.1%
Colorado$8$31517232,850+0.1%
Georgia$8$421,681705,6960.0%
Illinois$8$421,704740,2690.0%
Louisiana$8$33685206,4250.0%
Missouri$8$38929221,6300.0%
Montana$8$3413722,2440.0%
Nebraska$8$24571138,2340.0%
North Dakota$8$5029053,0840.0%
Ohio$8$32884936,9550.0%
Oklahoma$8$29623344,1970.0%
Oregon$8$25804181,2720.0%
Texas$8$364,7652,521,6080.0%
Puerto Rico$8$959852,6980.0%
Connecticut$8$3634570,3770.0%
District of Columbia$8$39426,991-0.1%
Hawaii$8$2650133,746-0.1%
Indiana$8$32584214,929-0.1%
Iowa$8$311,270187,751-0.1%
Kentucky$8$34631160,188-0.1%
Maine$8$2131640,803-0.1%
Michigan$8$23727258,809-0.1%
Nevada$8$34280239,979-0.1%
South Dakota$8$3345845,944-0.1%
Utah$8$2194298,379-0.1%
Virginia$8$291,655628,719-0.1%
Wyoming$8$4817620,144-0.1%
Minnesota$8$483,813216,406-0.3%
South Carolina$8$411,408336,741-0.3%
Tennessee$8$292,790678,664-0.3%
Washington$8$341,571436,322-0.3%
Alabama$8$281,471796,555-0.3%
Alaska$8$5926723,142-0.3%
Arkansas$8$271,143288,509-0.3%
Idaho$8$2827535,123-0.4%
Vermont$8$33856,502-0.4%
Wisconsin$8$672,342279,552-0.4%
West Virginia$8$3519833,510-0.5%
Mississippi$8$381,274246,817-0.7%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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