CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $22
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 4.30x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Munson Healthcare Otsego Memorial Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.30x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $35 (684%)
Insurance Median: $22 (430%)
Cash: $35 (684% of Medicare)
Ins. Median: $22 (430% 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 430% of the Medicare baseline (a markup of 330%). 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 $1 - $29 20%
UnitedHealthcare $2 - $38 39%
Mclaren Health Plan $3 - $39 59%
Meridian $3 59%
Molina $3 - $6 59%
Priority Health $3 - $12 59%
Aetna $4 - $38 78%
Blue Care Network $5 98%
Cigna $5 - $12 98%
Hap (Health Alliance Plan) $5 - $38 98%
Humana $5 98%
Medicare (plans) $5 98%
Michigan Amish Medical Board $5 98%
Northern Michigan Mennonite Group $5 98%
Employee Benefit Logistics $9 176%
Hospice Of Michigan $16 - $28 313%
Munson Hospice $18 - $852 352%
Asr Physicians Care Network $21 - $38 410%
Enterprise Group Planning/Employee Benefit Plan $21 - $38 410%
Nomi Health $21 - $38 410%
Cofinity $22 - $42 430%
Provider Network Of America/Hawaii Mainland Administrative Group Health $22 - $40 430%
Three Rivers Provider Network $22 - $40 430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals