CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Woodlawn Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $17
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 3.32x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Woodlawn Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.32x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $57 (1113%)
Insurance Median: $17 (332%)
Cash: $57 (1113% of Medicare)
Ins. Median: $17 (332% 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 332% of the Medicare baseline (a markup of 232%). 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 - $58 39%
Partners Direct Health-All Plans $4 78%
UnitedHealthcare $4 - $58 78%
Caresource Mcaid Hww $5 98%
Mdwise Excel Hhw & Hcc $5 98%
Mhs Mcaid Hcc $5 98%
Mhs Mcaid Hhw $5 98%
Aetna $17 - $72 332%
Caresource Mcaid Hip $17 332%
Caresource Mcr Adv $17 332%
Humana $17 - $59 332%
Mdwise Mcaid Excel Hip $17 332%
Mhs Exch Mrktplce-All Other Plans $17 332%
Mhs Mcaid Hip $17 332%
Mhs Mcr Adv $17 332%
Ambetter / Centene $22 430%
Caresource Exch - All Other Plans $22 430%
Cigna $54 - $65 1055%
Parkview Health Plans-All Plans $57 1113%
Sagamore All Other Grps - All Other Plans $64 1250%
Encore Comm-All Plans $65 1270%
Phcs/Multiplan-All Plans $71 1387%
Community Health Alliance-All Plans $72 1406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals