CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Saint Joseph Regional Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $28
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Saint Joseph Regional Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.47x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $70 (1367%)
Insurance Median: $28 (547%)
Cash: $70 (1367% of Medicare)
Ins. Median: $28 (547% 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 547% of the Medicare baseline (a markup of 447%). 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
Aetna $3 - $70 59%
Blue Cross Blue Shield $3 - $10 59%
Medicaid / KanCare $3 - $5 59%
UnitedHealthcare $3 - $68 59%
County Coroner $5 98%
Managed Health Services - Indiana $5 98%
Mdwise $5 98%
Medicare (plans) $5 98%
Meridian Complete $5 98%
Pace-Trinity Health $5 98%
Provider Partners Health Plan Of Indiana $6 117%
Bureau Of Disability $7 137%
Auxiant $8 - $89 156%
Caresource $8 156%
Physicians Health Plan Northern Indiana Health Insurance $8 - $15 156%
Siho Insurance Services $8 156%
St Joseph County Hlth Dpt $8 156%
Key Benefit Administrator $9 - $67 176%
Allied Benefit Systems $10 - $70 195%
Blue Benefit Administrators Of Massachusetts $10 195%
Blue Care Network $10 195%
Blue Distinction Transplant $10 195%
Blue Shield - Ca $10 195%
Blue Shield - Id (Regence) $10 195%
Blue Shield - Ny Highmark Northeastern $10 195%
Blue Shield - Ny Highmark Western $10 195%
Blue Shield - Pa (Highmark) $10 195%
Blue Shield - Wa (Regence) $10 195%
Custom Design Benefits $11 215%
Hospice Of Marshall County $28 547%
Hospice Of St Joseph County $28 547%
Plain Church Group $29 566%
Notre Dame Athletic Association $59 1152%
Wc Notre Dame $59 1152%
Luminare Health (Detroit) $61 - $64 1191%
Encore Health $63 - $67 1230%
Ameriben $64 1250%
Indiana Criminal Justice Inst $67 1309%
Western & Southern Financial Group $67 1309%
Cigna $68 1328%
Geha $68 1328%
Group Administrators $68 1328%
Health Partners $68 1328%
Healthscope $68 1328%
Mvp $68 1328%
Prairie States $68 1328%
Priority Health $68 1328%
Professional Benefit Administrators $68 1328%
Sagamore Health Network $68 - $79 1328%
Sisco Benefits $68 1328%
Student Insurance Cma $68 1328%
Unified Group Services $68 1328%
Asr Health Benefits $70 1367%
Christian Brother Services $70 1367%
Employee Benefit Management $70 1367%
Medical Mutual $70 1367%
Meritain $70 1367%
Preferred One $70 1367%
Rural Carrier Health Benefit Plan $70 1367%
Webtpa $70 1367%
Goshen Preferred Network $82 - $92 1602%
Christian Brothers Holy Cross $86 1680%
Signature Care $86 1680%
Bankers Life Casualty $107 2090%
Wc Align Network $107 2090%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals