CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $18
  • Cash Discount Price: $256
  • vs. Medicare Baseline: 3.52x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Central Florida Lake Monroe Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.52x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$256

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $256 (5000%)
Insurance Median: $18 (352%)
Cash: $256 (5000% of Medicare)
Ins. Median: $18 (352% 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 352% of the Medicare baseline (a markup of 252%). 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
Aetna $5 - $77 98%
Align Senior Care $5 98%
American Health Plan $5 98%
Avmed $5 - $128 98%
Blue Cross Blue Shield $5 98%
Cigna $5 98%
Devoted Health $5 98%
Fl Health Care Plan $5 98%
Florida Complete Care $5 98%
Humana $5 - $51 98%
Ndms Definitive Care $5 98%
Sunshine State $5 98%
United $5 - $115 98%
Wellcare $5 98%
Wellmed $5 98%
Careplus $6 117%
Centurion $6 117%
Clear Spring Health $6 117%
Gold Kidney Of Florida $6 117%
Longevity Health Plan $6 117%
Seminole County Sheriffs Office $6 117%
Ultimate Health Plan $6 117%
Oscar $7 137%
Solis Health Plan $7 137%
Simply Healthcare $8 156%
Freedom Health $18 352%
Optimum $18 352%
Simply $39 762%
Molina Healthcare $49 - $82 957%
Corvel Corporation $51 996%
Prime Health $52 1016%
Careworks (Rockport Community) $54 1055%
Evolutions $59 1152%
Sunshine State Health Plan $65 1270%
Florida Health Care Plan $96 1875%
Plotkin Health $128 2500%
Prime Health Sheriff $128 2500%
Multiplan $192 - $217 3750%
Three Rivers Provider Network $192 3750%
Ppo Next $217 4238%
Novanet $230 4492%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals