CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Decatur County Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $47
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 9.18x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Decatur County Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 9.18x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $46 (898%)
Insurance Median: $47 (918%)
Cash: $46 (898% of Medicare)
Ins. Median: $47 (918% 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 918% of the Medicare baseline (a markup of 818%). 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
UnitedHealthcare $3 - $49 59%
Blue Cross Blue Shield $18 - $19 352%
Wellmark Hmo $20 391%
Wellmark Ppo - All Other Plans $23 449%
Champva -All Plans $25 - $26 488%
Everystep Hospice-All Plans $29 - $30 566%
Aetna $30 - $46 586%
Tricare $30 - $31 586%
Benefit Admin System-All Plans $36 - $38 703%
Humana $41 - $42 801%
Meritain Health-All Plans $41 - $42 801%
Misc Commercial-All Plans $41 - $42 801%
All Savers-All Plans $42 - $44 820%
Allied Benefit System-All Plans $42 - $44 820%
American Family Ins Grp-All Plans $42 - $44 820%
Rural Carrier Benefit Plan-All Plans $43 - $45 840%
Christian Healthcare -All Plans $45 - $46 879%
Medica-All Other Plans $45 - $46 879%
Cigna $48 - $50 938%
Golden Rule-All Plans $48 - $49 938%
Ntca The Rural Broadband-All Plans $48 - $49 938%
Medical Mutual-All Plans $49 - $51 957%
Farm Bureau Financial-All Other Plans $50 - $52 977%
Farm Bureau Property And Ca $50 - $52 977%
Medi Share-All Plans $51 - $53 996%
Uhss-All Plans $51 - $53 996%
Health Partners-All Plans $52 - $53 1016%
Lewermark-All Plans $53 - $55 1035%
Mail Handlers Benefit-All Plans $55 - $57 1074%
Midlands Choice-All Plans $55 - $57 1074%
Priority Health-All Plans $56 - $58 1094%
Iowa Total Care Mcaid-All Plans $57 - $59 1113%
Amerigroup Mcaid-All Plans $59 - $61 1152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals