CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Shenandoah Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $21
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 4.10x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Shenandoah Medical Center is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.10x the Medicare baseline. Located in 300 Pershing Avenue, Shenandoah, IA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $40 (781%)
Insurance Median: $21 (410%)
Cash: $40 (781% of Medicare)
Ins. Median: $21 (410% 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 410% of the Medicare baseline (a markup of 310%). 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 $5 - $61 98%
Blue Cross Blue Shield $7 137%
Home State Health Plan Mcaid-All Plans $20 391%
Molina Mcd $20 391%
Nebraska Total Care Mcaid-All Plans $20 391%
Aetna $21 - $60 410%
Amerigroup Mcaid-All Plans $21 410%
Iowa Total Care Mcaid-All Plans $21 410%
Molina Mcr - All Other Plans $21 410%
Tricare $21 410%
Triwest Wellmark - All Plans $21 410%
Wellcare Mcr Adv - All Plans $21 410%
Midlands Choice-All Plans $58 1133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Pershing Avenue, Shenandoah, IA 51601
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals