CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $68
  • Cash Discount Price: $61
  • vs. Medicare Baseline: 13.28x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at HSHS St Elizabeth's Hospital is $68. 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 13.28x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$61

Average discount available for prompt cash payment at this facility.

Insurance Median
$68

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: $68 (1328%)
Cash: $61 (1191% of Medicare)
Ins. Median: $68 (1328% 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 1328% of the Medicare baseline (a markup of 1228%). 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
Meridian Health Plan $4 78%
Molina Healthcare $4 - $5 78%
Aetna $5 - $60 98%
Blue Cross Blue Shield $5 - $85 98%
Clear Spring Health Of Illinois $5 98%
Health Alliance Medical Plans $5 - $72 98%
Health Partners $5 98%
Humana $5 98%
Illinois Breast And Cervical Cancer Program $5 98%
Sae Hospice $5 98%
UnitedHealthcare $5 - $85 98%
Celtic Insurance Company $11 215%
Naphcare $12 234%
Claim Doc $13 254%
Hopetrust $13 254%
Amish Community $24 469%
Wellfirst $55 1074%
First Health $63 1230%
Cigna $67 - $85 1309%
Caterpillar, Inc. $68 1328%
Healthlink $68 - $85 1328%
Consociate Group $75 1465%
Choicecare $76 1484%
Healthcare Finest Network (Hfn) $76 1484%
Multiplan/Phcs $76 1484%
Provider Network Of America $76 1484%
City Of Springfield $85 1660%
Current Health Solutions $85 1660%
Healthscope $85 1660%
Interplan $85 1660%
Live360 $85 1660%
Wexford $85 1660%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals