CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Clay County Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $54
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 10.55x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Clay County Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 10.55x the Medicare baseline. Located in 911 Stacy Burk Dr, Flora, IL.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $87 (1699%)
Insurance Median: $54 (1055%)
Cash: $87 (1699% of Medicare)
Ins. Median: $54 (1055% 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 1055% of the Medicare baseline (a markup of 955%). 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 $2 - $70 39%
Blue Cross Blue Shield $4 - $64 78%
Aetna $23 - $69 449%
Ambetter / Centene $23 449%
Medica(Wellfirst) $23 - $54 449%
Meridian $23 449%
Wellcare $23 449%
Healthlink $57 - $70 1113%
Cigna $70 1367%
Usa Mco $83 1621%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 911 Stacy Burk Dr, Flora, IL 62839
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals