CMS Price Transparency Data
Blood test, creatinine (kidney)
Facility: Mercy Health Saint Mary's
Billing Code: 82565 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82565
- Insurance Median: $41
- Cash Discount Price: $36
- vs. Medicare Baseline: 8.01x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mercy Health Saint Mary's is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.01x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$36
Average discount available for prompt cash payment at this facility.
Insurance Median
$41
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: $36 (703%)
Insurance Median: $41 (801%)
Cash: $36 (703% of Medicare)
Ins. Median: $41 (801% 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 801% of the Medicare baseline (a markup of 701%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| U Of M Health Plan | $2 - $43 | 39% |
| Blue Cross Blue Shield | $3 - $5 | 59% |
| Medicaid / KanCare | $3 | 59% |
| Access Health | $4 | 78% |
| Aetna | $5 - $25 | 98% |
| Align Senior Care | $5 | 98% |
| Blue Care Network Advantage | $5 | 98% |
| Correctional Recovery | $5 | 98% |
| Hospice Faith | $5 | 98% |
| Hospice Of Holland | $5 | 98% |
| Medicare (plans) | $5 | 98% |
| Oscar | $5 | 98% |
| UnitedHealthcare | $5 - $56 | 98% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $6 | 117% |
| Molina Marketplace | $7 | 137% |
| Geha | $8 - $43 | 156% |
| Medical Mutual | $8 | 156% |
| Meritain | $8 | 156% |
| Preferred One | $8 | 156% |
| Vitalcore | $8 | 156% |
| Wellpath | $8 | 156% |
| Priority Health | $29 - $30 | 566% |
| Nomi Health | $31 | 605% |
| Wc Accident Fund | $31 | 605% |
| Wc Advantage | $31 | 605% |
| Wc Aig | $31 | 605% |
| Wc Allied | $31 | 605% |
| Wc Amerisure | $31 | 605% |
| Wc Amtrust | $31 | 605% |
| Wc Asu Risk Mgt | $31 | 605% |
| Wc Berkley Admin | $31 | 605% |
| Wc Broadspire | $31 | 605% |
| Wc Bunch & Associates | $31 | 605% |
| Wc Ccmsi | $31 | 605% |
| Wc Emc Insurance Company | $31 | 605% |
| Wc Esis | $31 | 605% |
| Wc Fcci | $31 | 605% |
| Wc Federated | $31 | 605% |
| Wc Gallagher Bassett | $31 | 605% |
| Wc Genex Care For Ohio | $31 | 605% |
| Wc Guard Insurance Company | $31 | 605% |
| Wc Hartford | $31 | 605% |
| Wc Liberty Mutual | $31 | 605% |
| Wc Meijers | $31 | 605% |
| Wc Michigan | $31 | 605% |
| Wc Mitchell Frankenmuth | $31 | 605% |
| Wc Pma | $31 | 605% |
| Wc Sedgwick | $31 | 605% |
| Wc Sentry | $31 | 605% |
| Wc Travelers | $31 | 605% |
| Wc Tristar | $31 | 605% |
| Wc Walmart | $31 | 605% |
| Wc Zurich | $31 | 605% |
| Acs Benefit Services | $32 | 625% |
| Allied Benefit Systems | $32 | 625% |
| Claimchoice Adminstrators | $32 | 625% |
| Consociate | $32 | 625% |
| Cypress Benefit Administrators | $32 | 625% |
| Forest County Potawatomi | $32 | 625% |
| Health Smart | $32 | 625% |
| Healthgram | $32 | 625% |
| Healthscope | $32 | 625% |
| Secureone Preferred United Plans | $32 | 625% |
| Sisco Benefits | $32 | 625% |
| The Health Plan | $32 | 625% |
| Trustmark Small Business Benefits | $32 | 625% |
| Unified Group Services | $32 | 625% |
| Webtpa | $32 | 625% |
| Asr Health Benefits | $36 | 703% |
| Hap | $36 - $43 | 703% |
| Varipro | $36 | 703% |
| Caresource | $37 | 723% |
| 1199 National Benefit Fund | $41 | 801% |
| Allied National Global Care | $41 | 801% |
| Asrm - Reliance Standard Life Insurance | $41 | 801% |
| Christian Care Ministry | $41 | 801% |
| Cigna | $41 | 801% |
| Dean Health | $41 | 801% |
| Fallon Health | $41 | 801% |
| Family Life Insurance Company | $41 | 801% |
| Ghc Scw | $41 | 801% |
| Group Pension Administrators | $41 | 801% |
| International Benefit Administrators | $41 | 801% |
| Lifetime Benefit Solutions | $41 | 801% |
| Manhattan Life | $41 | 801% |
| Medi Share | $41 | 801% |
| Multiplan | $41 | 801% |
| Mvp | $41 | 801% |
| Pai | $41 | 801% |
| Pan-American Life | $41 | 801% |
| Paramount Hmo | $41 | 801% |
| Phcs | $41 | 801% |
| Trinity Health Share | $41 | 801% |
| Acclaim | $43 | 840% |
| Administrative Concepts | $43 | 840% |
| Allegeant | $43 | 840% |
| Ameriben | $43 | 840% |
| American Family | $43 | 840% |
| American Healthcare Alliance | $43 | 840% |
| American Republic | $43 | 840% |
| Amerihealth | $43 | 840% |
| Aultcare | $43 | 840% |
| Automated Benefit Services | $43 | 840% |
| Auxiant | $43 | 840% |
| Benefit Administrative Systems,Llc | $43 | 840% |
| Boon Chapman | $43 | 840% |
| Cam Administrative Services | $43 | 840% |
| Christian Brother Services | $43 | 840% |
| Christian Brothers Holy Cross | $43 | 840% |
| Comprehensive Benefits | $43 | 840% |
| Continental Life Insurance | $43 | 840% |
| Custom Benefit Administrators | $43 | 840% |
| Employee Benefit Concepts | $43 | 840% |
| Employee Benefit Management | $43 | 840% |
| Enterprise Group Planning | $43 | 840% |
| Freedom Life Insurance Company | $43 | 840% |
| Group Administrators | $43 | 840% |
| Group Marketing Services | $43 | 840% |
| Guardian | $43 | 840% |
| Health America | $43 | 840% |
| Health Choices | $43 | 840% |
| Healthez | $43 | 840% |
| Humana | $43 - $56 | 840% |
| Insight | $43 | 840% |
| Intercare | $43 | 840% |
| Jfp Benefit Management | $43 | 840% |
| Jp Farley Corporation | $43 | 840% |
| Key Benefit Administrator | $43 | 840% |
| Liberty Union Life Assurance Co | $43 | 840% |
| Lucent Health | $43 | 840% |
| Luminare Health | $43 | 840% |
| Luminare Health (Detroit) | $43 | 840% |
| Medben | $43 | 840% |
| Medcost | $43 | 840% |
| Mutual Health Services | $43 | 840% |
| Mutual Of Omaha | $43 | 840% |
| Ncas | $43 | 840% |
| Nippon Life Ins | $43 | 840% |
| Nova | $43 | 840% |
| Painters Union Insurance Fund | $43 | 840% |
| Physicians Mutual | $43 | 840% |
| Plumbers Local 98 Insurance Fund | $43 | 840% |
| Prairie States | $43 | 840% |
| Primary Physician Care | $43 | 840% |
| Professional Benefit Administrators | $43 | 840% |
| The Loomis Company | $43 | 840% |
| Unicare | $43 | 840% |
| Us Health And Life | $43 | 840% |
| Valenz | $43 | 840% |
| Western & Southern Financial Group | $43 | 840% |
| Wps | $43 | 840% |
| Coventry | $44 | 859% |
| First Health | $44 | 859% |
| Cmh Allegan County | $56 | 1094% |
| Cmh Ausable Valley | $56 | 1094% |
| Cmh Barry County | $56 | 1094% |
| Cmh Berrien County | $56 | 1094% |
| Cmh Cass County | $56 | 1094% |
| Cmh Clinton-Eaton-Ingham County | $56 | 1094% |
| Cmh Kalamazoo | $56 | 1094% |
| Cmh Kent County | $56 | 1094% |
| Cmh Lenawee County | $56 | 1094% |
| Cmh Misc | $56 | 1094% |
| Cmh Monroe County | $56 | 1094% |
| Cmh Montcalm County | $56 | 1094% |
| Cmh Muskegon County | $56 | 1094% |
| Cmh Newaygo County | $56 | 1094% |
| Cmh North Country | $56 | 1094% |
| Cmh Northern Lakes County | $56 | 1094% |
| Cmh Ottawa County | $56 | 1094% |
| Cmh Van Buren County | $56 | 1094% |
| Cmh West Mi County | $56 | 1094% |
| Magellan Behavioral Health | $56 | 1094% |