Blood Test · 85048

Automated White Blood Cell Count

What Medicare pays for 85048, what providers bill, and how the price varies across 41 states, drawn from CMS 2023 claims data.

85048 · the short answer

For automated white blood cell count, Medicare pays about $2.47 on average across 41 states. This is a low-payment administrative or drug code, so the billed-to-paid ratio is not a meaningful "markup."

Medicare pays
$2.47
Providers bill
$16.66
States with data
41

Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.

Medicare Payment (avg)
$2.47
What Medicare actually pays
Billed Charge (avg)
$16.66
What providers submit
Markup
6.7x
574% above Medicare rate
34.4K
Total Services
17.3K
Beneficiaries
1.2K
Providers
41
States with Data

Price Range Across States

Lowest State Avg
$1.86
Arkansas
Highest State Avg
$2.51
South Dakota

What You Might Pay

Est. Commercial Insurance
$5.54
Range: $3.88 – $7.75
Est. Cash / Self-Pay
$6.44
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Blood Test procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Prices by State

State Medicare Payment Billed Charge
South Dakota $2.51 $18.31
Puerto Rico $2.49 $2.97
Georgia $2.49 $10.58
Illinois $2.49 $10.30
Kansas $2.49 $9.40
Kentucky $2.49 $8.99
Louisiana $2.49 $14.23
Maryland $2.49 $8.61
Massachusetts $2.49 $8.42
Mississippi $2.49 $14.75
Missouri $2.49 $5.24
Nevada $2.49 $8.04
New York $2.49 $10.60
North Dakota $2.49 $21.55
Oklahoma $2.49 $9.04
Oregon $2.49 $20.53
Rhode Island $2.49 $22.56
South Carolina $2.49 $29.25
Wyoming $2.49 $64.00
Hawaii $2.49 $7.80
Washington $2.49 $17.12
Colorado $2.49 $6.99
New Hampshire $2.49 $9.26
Florida $2.49 $9.14
Pennsylvania $2.48 $33.12
California $2.48 $17.08
Virginia $2.48 $9.26
New Jersey $2.48 $7.44
Iowa $2.48 $9.20
Tennessee $2.48 $7.09
Texas $2.48 $16.09
Michigan $2.48 $9.49
North Carolina $2.47 $24.48
Ohio $2.47 $21.77
Minnesota $2.45 $10.70
Arizona $2.43 $9.86
Alabama $2.42 $18.73
Connecticut $2.41 $20.83
Wisconsin $2.41 $42.12
Indiana $2.39 $30.50
Arkansas $1.86 $5.57

What the Data Says About Automated White Blood Cell Count

Across 41 states with reporting providers, CPT code 85048 (Automated White Blood Cell Count) shows a national average Medicare payment of $2.47 against an average billed charge of $16.66. That gap, a 6.7x markup, or 574% above the Medicare allowed amount, is not a meaningful ratio for this low-payment code, so treat the billed figure as a chargemaster reference point rather than a real-world price.

Blood Test procedures like this one saw 34.4K services billed to Medicare in 2023 by 1.2K distinct providers, serving 17.3K unique beneficiaries. State-level variation is significant: Arkansas reports the lowest average payment at $1.86, while South Dakota reports the highest at $2.51. The 35% spread here is a moderate, fairly ordinary GPCI effect, local cost-of-practice adjustments nudging the allowed amount up or down without reshaping it.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Blood Test category (2.24x), the estimated commercial insurance price lands near $5.54, with self-pay cash discounts commonly bringing the figure closer to $6.44. Within Blood Test, Automated White Blood Cell Count ranks #143 of 145 tracked procedures by national average Medicare payment.

What to do with this

If you may have automated white blood cell count done, these steps turn the numbers above into a real-world cost estimate.

  • Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
  • Compare automated white blood cell count costs in your state, Medicare rates vary by locality. Browse states
  • Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
  • Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide

Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.

Frequently Asked Questions

How much does Automated White Blood Cell Count cost?

Medicare's national average payment for Automated White Blood Cell Count (CPT 85048) is $2.47, with providers billing $16.66 on average; state rates run from $1.86 to $2.51, a meaningful but not extreme spread.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Automated White Blood Cell Count cost with insurance?

With commercial insurance, automated white blood cell count costs an estimated $5.54 on average (range: $3.88-$7.75), a moderate premium over Medicare's $2.47. Without insurance, the estimated cash price is $6.44.

Which state has the lowest cost for Automated White Blood Cell Count?

Arkansas has the lowest average Medicare payment for Automated White Blood Cell Count at $1.86, while South Dakota has the highest at $2.51 - a meaningful $0.65 spread.

How many providers perform Automated White Blood Cell Count?

A moderate provider base performs Automated White Blood Cell Count: 1.2K providers nationally, totaling 34.4K Medicare-billed services (17.3K beneficiaries) across 41 states in 2023.

What is the billed-to-Medicare markup for Automated White Blood Cell Count?

Providers bill 6.7x what Medicare pays for Automated White Blood Cell Count - a markup within the typical range at 574% above the Medicare rate.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.