CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Mc Donough District Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $30
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 5.86x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mc Donough District Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.86x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $25 (488%)
Insurance Median: $30 (586%)
Cash: $25 (488% of Medicare)
Ins. Median: $30 (586% 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 586% of the Medicare baseline (a markup of 486%). 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
Health Alliance $3 - $32 59%
Aetna $5 - $36 98%
Hfn $5 - $32 98%
Humana $5 - $32 98%
Medicaid / KanCare $5 - $36 98%
Medicare (plans) $5 98%
Meridian $5 98%
Molina $5 - $36 98%
Mutual Medical $5 - $36 98%
Tricare $5 98%
UnitedHealthcare $5 - $32 98%
Veteran Affairs $5 98%
Blue Cross Blue Shield $6 - $36 117%
Springfield Health $30 586%
Consociate $31 605%
Trilogy $31 605%
Blue Choice $32 625%
Current Health $32 625%
Healthlink $32 - $34 625%
Preferred Plan $34 664%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals