CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Veterans Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $36
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 7.03x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Veterans Memorial Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 7.03x the Medicare baseline. Located in 40 1St Street Se, Waukon, IA.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $48 (938%)
Insurance Median: $36 (703%)
Cash: $48 (938% of Medicare)
Ins. Median: $36 (703% 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 703% of the Medicare baseline (a markup of 603%). 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
Amerigroup Mcaid - All Other Plans $5 98%
Wellmark Hmo - All Other Plans $5 98%
Wellmark Ppo $6 117%
Amerigroup Mcr Adv $36 703%
Humana $36 - $63 703%
Iowa Total Care Exchange $36 703%
Iowa Total Care Mcr Adv $36 703%
Medica Mcr Adv $36 703%
Molina Mcr Adv $36 703%
Quartz Mcr Adv $36 703%
UnitedHealthcare $36 - $71 703%
Welmark Mcr Adv $36 703%
Iowa Total Care Mcaid - All Other Plans $43 840%
Molina Mcaid - All Other Plans $43 840%
Quartz Comm - All Other Plans $63 1230%
Medica Comm - All Other Plans $67 1309%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 40 1St Street Se, Waukon, IA 52172
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals