CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Monroe County Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $50
Cash Discount Price: $61
vs. Medicare Baseline: 9.77x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Monroe County Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 9.77x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $61 (1191%)

Insurance Median: $50 (977%)

Cash: $61 (1191% of Medicare)

Ins. Median: $50 (977% 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 977% of the Medicare baseline (a markup of 877%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Va Ccn - All Plans	$5	98%
Wellmark Hmo	$6	117%
Wellmark Ppo - All Other Plans	$7	137%
Mahp Mcare - All Plans	$42	820%
Tricare	$42	820%
UnitedHealthcare	$42 - $96	820%
Aetna	$43 - $95	840%
Amerigroup Mcare	$43	840%
Humana	$43	840%
Wellmark Mcare	$43	840%
Iowa Total Care Mcaid - All Plans	$50	977%
Molina Mcaid - All Plans	$51	996%
Amerigroup Mcaid - All Other Plans	$52	1016%
Centivo - All Plans	$64	1250%
Midlands Choice - All Plans	$71	1387%
Preferred Hlth - All Plans	$76	1484%
Geha - All Plans	$81	1582%
Multiplan - All Plans	$91	1777%
Integrated Hp - All Plans	$98	1914%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $61.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Monroe County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.