Complete blood count (CBC) at Samuel Mahelona Memorial Hospital. CPT 85025.
What Samuel Mahelona Memorial Hospital publishes for this service, straight from its standard-charges file, last updated June 15, 2026.
Outpatient / ER
$74.10cash price (self-pay)
$114list price
$7.77–$111range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Hawaii Western Management Group | Commercial | $7.77 |
| Hawaii Medical Service Association | Commercial | $9.71 |
| Hawaii Medical Service Association | ABD | $10.74 |
| UnitedHealthcare | Medicaid | $10.74 |
| Hawaii Medical Service Association | Non-ABD | $11.28 |
| University Health Alliance | Commercial | $20.09 |
| AlohaCare | Medicaid | $57.00 |
| AlohaCare | Medicare | $57.00 |
| Hawaii Medical Service Association | Medicare | $57.00 |
| Humana | Medicare | $57.00 |
| Kaiser Permanente | Medicare | $57.00 |
| Ohana Health Plan | Medicaid | $57.00 |
| Ohana Health Plan | Medicare | $57.00 |
| UnitedHealthcare | Medicare | $57.00 |
| Kaiser Permanente | Medicaid | $58.14 |
| Devoted Health | Medicare | $62.70 |
| Health Management Network | Commercial | $96.90 |
| Kaiser Permanente | Commercial | $103 |
| MDX Hawaii | PPO | $111 |
Inpatient
$74.10cash price (self-pay)
$114list price
$96.90–$111range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Management Network | Commercial | $96.90 |
| Kaiser Permanente | Commercial | $103 |
| MDX Hawaii | PPO | $111 |
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