CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Carle Eureka Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $45
Cash Discount Price: $100
vs. Medicare Baseline: 8.79x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Carle Eureka Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.79x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $100 (1953%)

Insurance Median: $45 (879%)

Cash: $100 (1953% of Medicare)

Ins. Median: $45 (879% 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 879% of the Medicare baseline (a markup of 779%). 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
Humana	$4 - $49	78%
Aetna	$5 - $71	98%
Wellcare	$5	98%
Meridian	$6 - $52	117%
Molina	$12 - $52	234%
UnitedHealthcare	$28 - $67	547%
Community Partners Health Plan (Cphp)	$37 - $65	723%
Cigna	$38 - $67	742%
Healthlink	$40 - $70	781%
Blue Cross Blue Shield	$42 - $91	820%
Multiplan/Phcs	$46 - $81	898%

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 $100.
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 Carle Eureka 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.