Complete blood count (CBC) at St. Luke's Jerome Standard Charges. CPT 85025.
What St. Luke's Jerome Standard Charges publishes for this service, straight from its standard-charges file, last updated March 25, 2026.
Outpatient / ER
$35.00cash price (self-pay)
$35.00list price
$7.77–$33.25range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $7.77 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $7.77 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $7.77 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $7.77 |
| Commercial [1028] | Hb Mv Slhp Select Health | $7.77 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $7.77 |
| Commercial [1028] | Hb Mv Va Ccn | $7.77 |
| Medicare Advantage Generic [1019] | Hb Mv Medicare Advantage | $7.77 |
| Medicare Advantage Generic [1019] | Hb Mv Molina Mmcp | $7.77 |
| Medicare Advantage Molina [1053] | Hb Mv Molina Mmcp | $7.77 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Pacificsource HMO PPO | $7.77 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $7.77 |
| Medicare Advantage Regence [1016] | Hb Mv Medicare Advantage | $7.77 |
| Blue Cross/Medicare Advantage [1009] | Hb Mv Bci True & Secure Med Adv | $7.85 |
| Medicare Advantage Generic [1019] | Hb Mv Molina Med Adv | $7.93 |
| Medicare Advantage Molina [1053] | Hb Mv Molina Med Adv | $7.93 |
| Medicare Advantage Aetna [1017] | Hb Mv Aetna Med Adv | $8.55 |
| Blue Cross Out Of State [1041] | Hb Mv Bci Out Of State | $17.48 |
| Blue Shield Alt [100401] | Hb Mv Regence Out Of State | $17.48 |
| Commercial [1028] | Hb Mv Regence PPO & Traditional | $17.48 |
| Commercial [1028] | Hb Mv H2b | $26.25 |
| H2b [1068] | Hb Mv H2b | $26.25 |
| Aetna [1021] | Hb Mv Bp Aetna | $28.00 |
| Cigna [1062] | Hb Mv Cigna | $28.00 |
| Commercial [1028] | Hb Mv Bp Aetna | $28.00 |
| Commercial [1028] | Hb Mv Cigna | $28.00 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $28.00 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $29.00 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $29.00 |
| Commercial [1028] | Hb Mv Amps | $29.75 |
Inpatient
$60.00cash price (self-pay)
$60.00list price
$39.00–$57.00range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Slplan Tap Mc St Lukes Health Plan [1641000001] | Hb Mv Slhp St Lukes | $39.00 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Carepoint Qhp | $39.00 |
| Blue Cross Idaho [1007] | Hb Mv Slhp Blue Cross Large Group | $39.00 |
| Commercial [1028] | Hb Mv Slhp Mountain Health Coop | $39.00 |
| Commercial [1028] | Hb Mv Slhp Select Health | $39.00 |
| Commercial [1028] | Hb Mv Slhp Select Health Qhp | $39.00 |
| Medicare Advantage Pacificsource [1039] | Hb Mv Slhp Pacificsource Med | $39.00 |
| Mountain Health Co-Op [1067] | Hb Mv Slhp Mountain Health Coop | $39.00 |
| Pacificsource [1020] | Hb Mv Pacificsource Navigator Large Group | $39.00 |
| Pacificsource [1020] | Hb Mv Slhp Pacificsource Navigator Qhp | $39.00 |
| Select Health [1063] | Hb Mv Slhp Select Health | $39.00 |
| Select Health [1063] | Hb Mv Slhp Select Health Qhp | $39.00 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Large Gr | $39.00 |
| St Lukes Health Plan [1046] | Hb Mv Slhp St Lukes Health Plan Qhp | $39.00 |
| Commercial [1028] | Hb Mv H2b | $45.00 |
| H2b [1068] | Hb Mv H2b | $45.00 |
| Pacificsource [1020] | Hb Mv Pacificsource PPO Voyager | $45.00 |
| Aetna [1021] | Hb Mv Bp Aetna | $48.00 |
| Cigna [1062] | Hb Mv Cigna | $48.00 |
| Commercial [1028] | Hb Mv Bp Aetna | $48.00 |
| Commercial [1028] | Hb Mv Cigna | $48.00 |
| Commercial [1028] | Hb Mv Multiplan Primary Network | $48.00 |
| Commercial [1028] | Hb Mv Va Ccn | $48.00 |
| Providence [1022] | Hb Mv Cigna | $48.00 |
| Commercial [1028] | Hb Mv Amps | $51.00 |
| Commercial [1028] | Hb Mv Christian Health Aid | $51.00 |
| Commercial [1028] | Hb Mv First Choice Health | $51.00 |
| First Health [1064] | Hb Mv First Choice Health | $51.00 |
| Blue Cross Federal [1008] | Hb Mv Bci PPO Fep | $51.30 |
| Blue Cross Idaho [1007] | Hb Mv Bci PPO Fep | $51.30 |
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