CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Modoc Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $90
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 17.58x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Modoc Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 17.58x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5.12

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.12 (100%)
Cash / Self-Pay: $104 (2031%)
Insurance Median: $90 (1758%)
Cash: $104 (2031% of Medicare)
Ins. Median: $90 (1758% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.12 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1758% of the Medicare baseline (a markup of 1658%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Integrated Hp Wc $5 98%
Multiplan Wc $5 98%
Ntwrks By Design Wc - All Plans $5 98%
Adv Med Mgmt - All Plans $6 117%
Medi-Cal $6 117%
Medi-Cal 7/1/24 $6 117%
Partnership Hp - All Plans $6 117%
Blue Shield Mcr Adv $56 1094%
Blue Shield Va $56 1094%
UnitedHealthcare $56 - $99 1094%
Tricare $59 1152%
Healthnet Mcr Adv $60 1172%
Blue Cross Blue Shield $85 - $95 1660%
Blue Shield Exch $85 1660%
Blue Shield Comm - All Other Plans $95 1855%
Carelon - All Plans $95 1855%
Corvel - All Plans $98 1914%
Aetna $99 1934%
Coventry/First Health - All Plans $99 1934%
Galaxy Health - All Plans $99 1934%
Healthnet Comm - All Other Plans $99 1934%
Hmn - All Plans $99 1934%
Integrated Hp - All Other Plans $99 1934%
Interplan - All Plans $99 1934%
Multiplan - All Other Plans $99 1934%
Superior Ca Ppo - All Plans $99 1934%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 N Nagle Street, Alturas, CA 96101
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals