CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Norton-King's Daughters' Health

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $45
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 8.79x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Norton-King's Daughters' Health is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.79x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$13

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: $13 (254%)
Insurance Median: $45 (879%)
Cash: $13 (254% 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.

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 $4 - $50 78%
Blue Cross Blue Shield $5 - $16 98%
Humana $5 98%
Managed Health Services $5 - $8 98%
Managed Health Services Of Indiana $5 98%
Managed Health Services Of Kentucky $5 98%
Passport By Molina $5 98%
UnitedHealthcare $5 - $45 98%
Caresource Of Kentucky $7 137%
Caresource Of Indiana $8 156%
Custom Design Benefits $10 - $28 195%
Cigna $48 938%
Encore $48 938%
Bluegrass $51 996%
First Health $51 996%
Healthlink $51 996%
Quality Care Partners $51 996%
Vha/Tristate $51 996%
Multiplan/Phcs $52 1016%
Indiana Health Network $54 1055%
Siho $54 1055%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals