CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: St Joseph's Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $66
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 12.89x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at St Joseph's Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 12.89x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $79 (1543%)
Insurance Median: $66 (1289%)
Cash: $79 (1543% of Medicare)
Ins. Median: $66 (1289% 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 1289% of the Medicare baseline (a markup of 1189%). 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
Illinois Breast and Cervical Cancer Program $5 98%
Meridian Health Plan $9 176%
Molina Healthcare $9 - $22 176%
Caterpillar, Inc. $10 195%
UnitedHealthcare $10 - $110 195%
Cigna $13 254%
Clear Spring Health of Illinois $22 430%
Aetna $22 - $77 430%
Humana $22 430%
Blue Cross Blue Shield $22 430%
Sae Hospice $22 430%
Amish Community $31 605%
Naphcare $46 898%
Celtic Insurance Company $48 938%
Claim Doc $55 1074%
Hopetrust $55 1074%
Wellfirst $70 1367%
First Health $81 1582%
Multiplan/Phcs $94 1836%
Healthlink $94 1836%
Healthcare Finest Network (Hfn) $99 1934%
Provider Network of America $99 1934%
Current Health Solutions $110 2148%
Healthscope $110 2148%
Qtc Medical Group of Illinois $110 2148%
Consociate Group $110 2148%
Mental Health Network $110 2148%
Interplan $110 2148%
Health Alliance Medical Plans $110 2148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals