Complete blood count (CBC) at Intermountain Health Good Samaritan Medical Center. CPT 85025.
What Intermountain Health Good Samaritan Medical Center publishes for this service, straight from its standard-charges file, last updated March 22, 2026.
Outpatient / ER
—cash price (self-pay)
$154list price
$5.05–$138range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Cigna | Cigna Co Public Option | $22.08 |
| Cigna | Cigna Connect Exchange | $22.08 |
| Cigna | Cigna Surefit | $22.08 |
| United Healthcare | Selectcolorado | $37.31 |
| BCBS/Anthem | BCBS Co Federal | $37.49 |
| BCBS/Anthem | BCBS Co HMO | $37.49 |
| BCBS/Anthem | BCBS Co PPO | $37.49 |
| Allegiance | Cigna Sclhs Employees | $38.42 |
| Cigna Scl Employees | Cigna Sclhs Cdhp | $38.42 |
| Cigna | Cigna HMO | $46.52 |
| Cigna | Cigna Indemnity | $46.52 |
| Cigna | Cigna Local Plus | $46.52 |
| Cigna | Cigna Other | $46.52 |
| Cigna | Cigna POS/Qpos | $46.52 |
| Cigna | Cigna PPO | $46.52 |
| Cigna | Eighth Dist Elect Ben Pln | $46.52 |
| Cigna | Health-Partners | $46.52 |
| Geha | Geha | $48.46 |
| Geha | Geha Mcr Supplemental | $48.46 |
| United Healthcare | All Savers Alternative Funding | $48.46 |
| United Healthcare | Golden Rule Ins | $48.46 |
| United Healthcare | Healthscope | $48.46 |
| United Healthcare | Medica | $48.46 |
| United Healthcare | Surest | $48.46 |
| United Healthcare | UHC Charter/Navigate | $48.46 |
| United Healthcare | UHC Exchange Plan | $48.46 |
| United Healthcare | Umr-United Med Resources | $48.46 |
| United Healthcare | United Healthcare | $48.46 |
| Aetna | Aetna Colorado Preferred | $57.18 |
| Aetna | Aetna HMO/EPO | $61.33 |
Inpatient
—cash price (self-pay)
$154list price
$45.34–$154range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Kaiser Perm HMO | Kp Select HMO | $45.34 |
| Kaiser Perm HMO | Kaiser HMO Exchange Plan | $64.75 |
| Kaiser Perm HMO | Kaiser Out Of State | $64.75 |
| Kaiser Perm HMO | Kaiser Permanente HMO | $64.75 |
| Kaiser Self Funded | Kaiser Self Funded | $64.75 |
| Kaiser Perm PPO/POS | Kaiser Perm PPO/POS | $66.72 |
| Private Hlthcare Sys | Phcs Other | $115 |
| Private Hlthcare Sys | Phcs PPO | $115 |
| BCBS/Anthem | BCBS Co Indemnity | $129 |
| Multiplan Inc | Multiplan Inc Other | $131 |
| Multiplan Inc | Multiplan Inc PPO | $131 |
| Aetna | Aetna Nap | $138 |
| Cigna | Cigna HMO | $154 |
| Cigna | Cigna Indemnity | $154 |
| Cigna | Cigna Local Plus | $154 |
| Cigna | Cigna Other | $154 |
| Cigna | Cigna POS/Qpos | $154 |
| Cigna | Cigna PPO | $154 |
| Cigna | Eighth Dist Elect Ben Pln | $154 |
| Cigna | Health-Partners | $154 |
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All common services at Intermountain Health Good Samaritan Medical Center