Complete blood count (CBC) at Good Samaritan Hospital (GSH). CPT 85025.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$60.00cash price (self-pay)
$100list price
$5.72–$100range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $7.77 |
| Allwell | MCR ADV/PPO/HMO | $7.77 |
| Anthem HIP | HIP | $7.77 |
| Anthem MCR | MCR ADV/PPO/HMO | $7.77 |
| Anthem MCR | Medicare Advantage | $7.77 |
| Anthem | MCR ADV/PPO/HMO | $7.77 |
| Anthem | Medicaid | $7.77 |
| BCBS | Medicare Advantage | $7.77 |
| Caresource HIP | Medicaid | $7.77 |
| Caresource | Medicaid | $7.77 |
| Cigna | Medicare Advantage | $7.77 |
| Humana | Medicare Advantage | $7.77 |
| United Healthcare | Medicare Advantage | $7.77 |
| Aetna | Medicaid | $7.77 |
| Anthem Pathways | Medicaid | $7.77 |
| Indiana University | MCR ADV/PPO/HMO | $7.77 |
| MHS Ambetter | Commercial | $7.77 |
| Alliance Coal | Commercial | $9.71 |
| CareSource | Commercial | $10.69 |
| Encore Prime | Commercial | $11.72 |
| Aetna | Commercial | $13.06 |
| Hope Trust | Commercial | $15.54 |
| Anthem | Trad/PPO/HMO | $38.52 |
| Direct Health | Direct Health | $42.23 |
| OneCare | Commercial | $43.15 |
| Anthem | HealthSync | $46.88 |
| Amish | Commercial | $50.00 |
| HealthLink | HMO | $53.50 |
| HealthLink | PPO | $56.50 |
| Anthem | Exchange | $57.06 |
Inpatient
$60.00cash price (self-pay)
$100list price
$58.18–$100range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Anthem | Exchange | $58.18 |
| United Healthcare | Commercial | $66.20 |
| Anthem | Trad/PPO/HMO | $72.72 |
| Direct Health | Direct Health | $76.70 |
| SIHO | Commercial | $76.70 |
| Cigna | Commercial | $79.00 |
| Sagamore | Commercial | $79.00 |
| Corvel | Workers Comp | $82.00 |
| Aetna | Commercial | $83.80 |
| Anthem | HealthSync | $86.00 |
| HealthLink | HMO | $88.00 |
| Encore Prime | Commercial | $90.00 |
| Humana | Commercial | $90.00 |
| HealthLink | PPO | $93.00 |
| Molina | Medicaid | $100 |
| Underwriters Safety | Commercial | $100 |
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