CMS Price Transparency Data
Blood test, creatinine (kidney)
Facility: Trinity Health Muskegon Hospital
Billing Code: 82565 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82565
- Insurance Median: $42
- Cash Discount Price: $36
- vs. Medicare Baseline: 8.20x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Trinity Health Muskegon Hospital is $42. 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 8.20x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$36
Average discount available for prompt cash payment at this facility.
Insurance Median
$42
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: $42 (820%)
Cash: $36 (703% of Medicare)
Ins. Median: $42 (820% 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 820% of the Medicare baseline (a markup of 720%). 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 - $44 | 39% |
| Blue Cross Blue Shield | $3 - $5 | 59% |
| Medicaid / KanCare | $3 | 59% |
| Access Health | $4 | 78% |
| Aetna | $5 - $24 | 98% |
| Align Senior Care | $5 | 98% |
| Blue Care Network Advantage | $5 | 98% |
| Correctional Recovery | $5 | 98% |
| Heartland Hospice | $5 | 98% |
| Hospice Harbor Hospice | $5 | 98% |
| Medicare (plans) | $5 | 98% |
| Oscar | $5 | 98% |
| UnitedHealthcare | $5 - $49 | 98% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $6 | 117% |
| Molina Marketplace | $7 | 137% |
| Geha | $8 - $49 | 156% |
| Meritain | $8 | 156% |
| Vitalcore | $8 | 156% |
| Wellpath | $8 | 156% |
| Priority Health | $25 - $28 | 488% |
| Acs Benefit Services | $29 | 566% |
| Allied Benefit Systems | $29 | 566% |
| Claimchoice Adminstrators | $29 | 566% |
| Consociate | $29 | 566% |
| Cypress Benefit Administrators | $29 | 566% |
| Forest County Potawatomi | $29 | 566% |
| Health Smart | $29 | 566% |
| Healthgram | $29 | 566% |
| Healthscope | $29 | 566% |
| Preferred One | $29 | 566% |
| Secureone Preferred United Plans | $29 | 566% |
| Sisco Benefits | $29 | 566% |
| The Health Plan | $29 | 566% |
| Trustmark Small Business Benefits | $29 | 566% |
| Unified Group Services | $29 | 566% |
| Webtpa | $29 | 566% |
| Asr Health Benefits | $30 | 586% |
| Hap | $30 - $44 | 586% |
| Wc Accident Fund | $30 | 586% |
| Wc Advantage | $30 | 586% |
| Wc Aig | $30 | 586% |
| Wc Allied | $30 | 586% |
| Wc Amerisure | $30 | 586% |
| Wc Amtrust | $30 | 586% |
| Wc Asu Risk Mgt | $30 | 586% |
| Wc Berkley Admin | $30 | 586% |
| Wc Broadspire | $30 | 586% |
| Wc Bunch & Associates | $30 | 586% |
| Wc Ccmsi | $30 | 586% |
| Wc Emc Insurance Company | $30 | 586% |
| Wc Esis | $30 | 586% |
| Wc Fcci | $30 | 586% |
| Wc Federated | $30 | 586% |
| Wc Gallagher Bassett | $30 | 586% |
| Wc Genex Care For Ohio | $30 | 586% |
| Wc Guard Insurance Company | $30 | 586% |
| Wc Hartford | $30 | 586% |
| Wc Liberty Mutual | $30 | 586% |
| Wc Meijers | $30 | 586% |
| Wc Michigan | $30 | 586% |
| Wc Mitchell Frankenmuth | $30 | 586% |
| Wc Pma | $30 | 586% |
| Wc Sedgwick | $30 | 586% |
| Wc Sentry | $30 | 586% |
| Wc Travelers | $30 | 586% |
| Wc Tristar | $30 | 586% |
| Wc Walmart | $30 | 586% |
| Wc Zurich | $30 | 586% |
| Hospice Of Michigan | $31 | 605% |
| Nomi Health | $31 | 605% |
| Varipro | $32 | 625% |
| Caresource | $35 | 684% |
| Cigna | $35 | 684% |
| 1199 National Benefit Fund | $42 | 820% |
| Allied National Global Care | $42 | 820% |
| Asrm - Reliance Standard Life Insurance | $42 | 820% |
| Christian Care Ministry | $42 | 820% |
| Dean Health | $42 | 820% |
| Fallon Health | $42 | 820% |
| Family Life Insurance Company | $42 | 820% |
| Ghc Scw | $42 | 820% |
| Group Pension Administrators | $42 | 820% |
| International Benefit Administrators | $42 | 820% |
| Lifetime Benefit Solutions | $42 | 820% |
| Manhattan Life | $42 | 820% |
| Medi Share | $42 | 820% |
| Multiplan | $42 | 820% |
| Mvp | $42 | 820% |
| Pai | $42 | 820% |
| Pan-American Life | $42 | 820% |
| Paramount Hmo | $42 | 820% |
| Phcs | $42 | 820% |
| Trinity Health Share | $42 | 820% |
| Acclaim | $44 | 859% |
| Administrative Concepts | $44 | 859% |
| Allegeant | $44 | 859% |
| Ameriben | $44 | 859% |
| American Family | $44 | 859% |
| American Healthcare Alliance | $44 | 859% |
| American Republic | $44 | 859% |
| Amerihealth | $44 | 859% |
| Aultcare | $44 | 859% |
| Automated Benefit Services | $44 | 859% |
| Auxiant | $44 | 859% |
| Benefit Administrative Systems,Llc | $44 | 859% |
| Boon Chapman | $44 | 859% |
| Cam Administrative Services | $44 | 859% |
| Christian Brother Services | $44 | 859% |
| Christian Brothers Holy Cross | $44 | 859% |
| Comprehensive Benefits | $44 | 859% |
| Continental Life Insurance | $44 | 859% |
| Custom Benefit Administrators | $44 | 859% |
| Employee Benefit Concepts | $44 | 859% |
| Employee Benefit Management | $44 | 859% |
| Enterprise Group Planning | $44 | 859% |
| Freedom Life Insurance Company | $44 | 859% |
| Group Administrators | $44 | 859% |
| Group Marketing Services | $44 | 859% |
| Guardian | $44 | 859% |
| Health America | $44 | 859% |
| Health Choices | $44 | 859% |
| Healthez | $44 | 859% |
| Humana | $44 | 859% |
| Insight | $44 | 859% |
| Intercare | $44 | 859% |
| Jfp Benefit Management | $44 | 859% |
| Jp Farley Corporation | $44 | 859% |
| Key Benefit Administrator | $44 | 859% |
| Liberty Union Life Assurance Co | $44 | 859% |
| Lucent Health | $44 | 859% |
| Luminare Health | $44 | 859% |
| Luminare Health (Detroit) | $44 | 859% |
| Medben | $44 | 859% |
| Medcost | $44 | 859% |
| Medical Mutual | $44 | 859% |
| Mutual Health Services | $44 | 859% |
| Mutual Of Omaha | $44 | 859% |
| Ncas | $44 | 859% |
| Nippon Life Ins | $44 | 859% |
| Nova | $44 | 859% |
| Painters Union Insurance Fund | $44 | 859% |
| Physicians Mutual | $44 | 859% |
| Plumbers Local 98 Insurance Fund | $44 | 859% |
| Prairie States | $44 | 859% |
| Primary Physician Care | $44 | 859% |
| Professional Benefit Administrators | $44 | 859% |
| The Loomis Company | $44 | 859% |
| Unicare | $44 | 859% |
| Us Health And Life | $44 | 859% |
| Valenz | $44 | 859% |
| Western & Southern Financial Group | $44 | 859% |
| Wps | $44 | 859% |
| First Health | $46 | 898% |
| Barinet | $56 | 1094% |
| Cmh Allegan County | $56 | 1094% |
| Cmh Barry County | $56 | 1094% |
| Cmh Berrien County | $56 | 1094% |
| Cmh Cass County | $56 | 1094% |
| Cmh Kalamazoo | $56 | 1094% |
| Cmh Kent County | $56 | 1094% |
| Cmh Misc | $56 | 1094% |
| Cmh Muskegon 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% |