CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Unity Physicians Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $21,318
Cash Discount Price: Unavailable
vs. Medicare Baseline: 4163.67x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Unity Physicians Hospital is $21,318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4163.67x the Medicare baseline. Located in 4455 Edison Lakes Pkwy, Mishawaka, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,318

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%)

Insurance Median: $21,318 (416367%)

Ins. Median: $21,318 (416367% 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 416367% of the Medicare baseline (a markup of 416267%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$5 - $33,080	98%
Medicaid / KanCare	$5	98%
Mhs Hoosier Care Connect	$5	98%
Nalc	$33 - $44,702	645%
Sagamore Health Network	$33 - $44,702	645%
Multiplan	$36	703%
Multiplan Wc	$44	859%
Aarp Supplemental	$21,318	416367%
Aetna	$21,318	416367%
Cigna	$21,318	416367%
Department Of Va	$21,318	416367%
Medicare (plans)	$21,318	416367%
Mhs Healthy Indiana Plan	$21,318	416367%
Railroad Retirement	$21,318	416367%
UnitedHealthcare	$21,318 - $44,702	416367%
Three Rivers Provider Network	$25,581	499629%
Humana	$29,845	582910%
Encore	$38,372	749453%
Provider Network Of America	$42,635	832715%
All Savers	$44,702	873086%
Medica	$44,702	873086%
Medica Ifb	$44,702	873086%
Oxford	$44,702	873086%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Unity Physicians Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.