CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $50
  • Cash Discount Price: $1,437
  • vs. Medicare Baseline: 9.77x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Saint Joseph Regional Medical Center - Plymouth is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,437. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 9.77x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$1,437

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $1,437 (28066%)
Insurance Median: $50 (977%)
Cash: $1,437 (28066% of Medicare)
Ins. Median: $50 (977% 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 977% of the Medicare baseline (a markup of 877%). 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 - $288 59%
Blue Cross Blue Shield $3 - $655 59%
Medicaid / KanCare $3 - $96 59%
UnitedHealthcare $3 - $399 59%
County Coroner $5 - $193 98%
Managed Health Services - Indiana $5 98%
Mdwise $5 98%
Medicare (plans) $5 - $189 98%
Meridian Complete $5 - $186 98%
Pace-Trinity Health $5 - $186 98%
Provider Partners Health Plan Of Indiana $6 - $204 117%
Bureau Of Disability $7 137%
Auxiant $8 - $399 156%
Caresource $8 - $288 156%
Physicians Health Plan Northern Indiana Health Insurance $8 - $560 156%
Siho Insurance Services $8 - $297 156%
St Joseph County Hlth Dpt $8 - $278 156%
Key Benefit Administrator $9 - $399 176%
Allied Benefit Systems $10 - $353 195%
Blue Benefit Administrators Of Massachusetts $10 - $655 195%
Blue Care Network $10 - $655 195%
Blue Distinction Transplant $10 - $655 195%
Blue Shield - Ca $10 - $655 195%
Blue Shield - Id (Regence) $10 - $655 195%
Blue Shield - Ny Highmark Northeastern $10 - $655 195%
Blue Shield - Ny Highmark Western $10 - $655 195%
Blue Shield - Pa (Highmark) $10 - $655 195%
Blue Shield - Wa (Regence) $10 - $655 195%
Custom Design Benefits $11 - $399 215%
Plain Church Group $19 371%
Asr Health Benefits $35 684%
Christian Brother Services $35 684%
Employee Benefit Management $35 684%
Medical Mutual $35 684%
Meritain $35 684%
Preferred One $35 684%
Rural Carrier Health Benefit Plan $35 684%
Webtpa $35 684%
Notre Dame Athletic Association $39 762%
Wc Notre Dame $39 762%
Luminare Health (Detroit) $40 - $43 781%
Ameriben $43 840%
Geha $45 879%
Healthscope $45 879%
Student Insurance Cma $45 879%
Encore Health $50 977%
Indiana Criminal Justice Inst $50 977%
Western & Southern Financial Group $50 977%
Cigna $51 996%
Group Administrators $51 996%
Health Partners $51 996%
Mvp $51 996%
Prairie States $51 996%
Priority Health $51 996%
Professional Benefit Administrators $51 996%
Sagamore Health Network $51 - $55 996%
Sisco Benefits $51 996%
Unified Group Services $51 996%
Goshen Preferred Network $55 - $61 1074%
Signature Care $59 1152%
Allied National Global Care $64 1250%
Asrm - Reliance Standard Life Insurance $64 1250%
Avmed Health Plan $64 1250%
Christian Care Ministry $64 1250%
Dean Health $64 1250%
Fallon Health $64 1250%
Family Life Insurance Company $64 1250%
Freedom Life Insurance Company $64 1250%
Ghc Scw $64 1250%
International Benefit Administrators $64 1250%
Lifetime Benefit Solutions $64 1250%
Manhattan Life $64 1250%
Medi Share $64 1250%
Multiplan $64 1250%
Pai $64 1250%
Pan-American Life $64 1250%
Paramount Hmo $64 1250%
Phcs $64 1250%
Philadelphia American Life Insurance $64 1250%
Trinity Health Share $64 1250%
Bankers Life Casualty $71 1387%
Wc Align Network $71 1387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals