CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Waverly Health Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $39
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 7.62x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Waverly Health Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 7.62x the Medicare baseline. Located in 312 9Th Street Sw, Waverly, IA.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $32 (625%)
Insurance Median: $39 (762%)
Cash: $32 (625% of Medicare)
Ins. Median: $39 (762% 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 762% of the Medicare baseline (a markup of 662%). 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
Choicecare Network - All Plans $23 449%
UnitedHealthcare $23 - $43 449%
Medicare (plans) $26 508%
Midlands Choice Mcare $26 508%
Wellmark Hmo $32 625%
Wellmark Ppo - All Other Plans $35 684%
Hlth Partners Bridges Ntwrk $42 820%
Hlth Partners Open Ntwrk - All Other Plans $42 820%
Aetna $52 1016%
Health Alliance-All Plans $55 1074%
Midlands Choice-All Other Plans $55 1074%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 312 9Th Street Sw, Waverly, IA 50677
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals