CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Northwest Health - Porter

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $12
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Northwest Health - Porter is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.34x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $40 (781%)
Insurance Median: $12 (234%)
Cash: $40 (781% of Medicare)
Ins. Median: $12 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Blue Cross Blue Shield $2 - $8 39%
Aetna $5 - $64 98%
Care Improvement Plus $5 98%
Caresource $5 98%
Healthy Indiana Plan $5 98%
Humana $5 98%
In Dept Of Correction $5 98%
Managed Health Services $5 - $10 98%
Medicaid / KanCare $5 98%
Medicare (plans) $5 98%
Mhs $5 98%
Node Devoted Health Mcr Adv $5 98%
Node Hospice Non Par Agree $5 98%
Node Mhs Mcr Adv $5 98%
Node Va $5 98%
Tricare $5 98%
UnitedHealthcare $5 - $39 98%
Veterans Eval Services $5 98%
Node Us Dept Of Labor $6 117%
Align Network $8 156%
One Call Work Comp $8 156%
Encore Health $9 - $102 176%
Prime Health $9 - $95 176%
Indiana Work Comp $10 195%
Lutheran Preferred $10 - $76 195%
Node Encore Kba Epo $12 234%
Porter County $12 234%
Preferred Network Access $12 234%
Magnacare Ma $13 254%
Lutheran Preferred Chs Employees $30 586%
Self Pay $34 - $46 664%
Cigna $35 684%
Physicians Health Plan $49 957%
Php Freedom $52 1016%
Sagamore Health Network $56 - $75 1094%
First Health Coventry $62 1211%
Encore Ppo $64 1250%
Southeastem Indiana Health Operations $89 - $95 1738%
Network Synergy Group $95 1855%
Multiplan/Phcs $107 2090%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals