CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Pulaski Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $32
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 6.25x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Pulaski Memorial Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 6.25x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $68 (1328%)
Insurance Median: $32 (625%)
Cash: $68 (1328% of Medicare)
Ins. Median: $32 (625% 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 625% of the Medicare baseline (a markup of 525%). 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 $5 - $65 98%
Caresource Mcaid Hhw $5 98%
Cenpatico Mcaid Hhw - All Other Plans $5 98%
Mdwise Mcaid Hcc $5 98%
Mdwise Mcaid Hhw $5 98%
Mhs Mcaid Hhw/Hcc $5 98%
UnitedHealthcare $5 - $77 98%
Ambetter / Centene $30 586%
Caresource Mcaid Hip $30 586%
Caresource Mcare Hmo $30 586%
Cenpatico Mcaid Hip $30 586%
Humana $30 - $78 586%
Mdwise Mcaid Hip - All Other Plans $30 586%
Mhs Mcaid Hip $30 586%
Mhs Mcare Allwell $30 586%
Aetna $35 684%
Caresource Exch Hmo Hix - All Other Plans $38 742%
Sagamore Rose Acre $72 1406%
Sagamore - All Other Plans $73 1426%
Encore Ppo - All Other Plans $82 1602%
Community Health Alliance - All Plans $86 1680%
Encore Workers Comp $87 1699%
Multiplan - All Plans $87 1699%
Cigna $92 1797%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 616 E 13Th St, Winamac, IN 46996
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals