Blood test, creatinine (kidney)

For this blood test for creatinine at Mercy Hospital Pittsburg, Inc., the facility's cash price of $42.00 is notably higher than the state average, which sits at $9.00. While the facility's negotiated rate is $8.00, this amount remains significantly above the state average of $9.00, indicating that commercial contracts in this region may not be driving down costs as expected. It is important to note that cash-paying can sometimes be more economical for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price, though in this specific case, the cash rate is the lowest available option compared to the state average. Patients should verify their specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price can lead to unexpected costs if the contract rate is higher than anticipated.

The facility's Medicare benchmark of $5.12 serves as the objective baseline for evaluating pricing, revealing that the cash price represents a markup well above the federal government's calculated cost. Although the facility is a voluntary non-profit church-owned hospital, its cash rate of $42.00 is substantially higher than the Medicare amount, which typically reflects the true cost of delivery. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it does not prevent balance billing for out-of-network ancillary services like certain lab tests. To ensure transparency, patients should request a full itemized bill before paying, as summary bills can obscure individual charges, and should inquire about prompt-pay discounts that could further reduce the final amount owed.