Complete blood count (CBC) at CHI Health Good Samaritan. CPT 85025.
What CHI Health Good Samaritan publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$85.40cash price (self-pay)
$140list price
$7.53–$130range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid|All Plans | $7.53 |
| Centene | Medicaid|IA Total Care | $7.53 |
| IAMolina | Medicaid|All Plans | $7.68 |
| BCBS - NE | Medicare|All Plans | $7.77 |
| Humana | Medicare|All Plans | $7.77 |
| Medica | Medicare|All Plans | $7.77 |
| PACE | Medicare|All Plans | $7.77 |
| United | Medicare|All Plans | $7.77 |
| Centene | Medicare|All Plans | $8.00 |
| Amerigroup | Medicare|All Plans | $8.16 |
| Great Plains | Medicare|All Plans | $8.16 |
| Medica | Commercial|ACO | $15.14 |
| Medica | Commercial|CHI Health | $15.98 |
| Medica | Commercial|All Other Plans | $16.73 |
| AMPS | Commercial|All Plans | $17.25 |
| United | Medicaid|Community Plan | $29.40 |
| Centene | Medicaid|NE Total Care | $29.70 |
| Greater Omaha Packing | Commercial|Narrow Network | $46.57 |
| Millard Public Schools | Commercial|Narrow Network | $46.57 |
| One World | Commercial|Narrow Network | $46.57 |
| Greater Omaha Packing | Commercial|Broad Network | $53.56 |
| Millard Public Schools | Commercial|Broad Network | $53.56 |
| One World | Commercial|Broad Network | $53.56 |
| Timpte | Commercial|Broad Network | $53.56 |
| Creighton University Employees | Commercial|All Plans | $68.60 |
| ELAP | Commercial|All Plans | $81.20 |
| United | Commercial|All Plans | $106 |
| Medica | Commercial|Open Access | $109 |
| Midlands Choice | Commercial|Premier | $109 |
| Midlands Choice | Commercial|Standard | $129 |
Inpatient
$85.40cash price (self-pay)
$140list price
$68.60–$130range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Creighton University Employees | Commercial|All Plans | $68.60 |
| United | Commercial|All Plans | $106 |
| Medica | Commercial|Open Access | $109 |
| Midlands Choice | Commercial|Premier | $109 |
| Midlands Choice | Commercial|Standard | $129 |
| MultiPlan PHCS | Commercial|All Plans | $130 |
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