CMS Price Transparency Data
Blood test, creatinine (kidney)
Facility: Mercy Health Lakeshore Campus
Billing Code: 82565 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82565
- Insurance Median: $48
- Cash Discount Price: $36
- vs. Medicare Baseline: 9.38x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mercy Health Lakeshore Campus is $48. 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 9.38x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$36
Average discount available for prompt cash payment at this facility.
Insurance Median
$48
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: $48 (938%)
Cash: $36 (703% of Medicare)
Ins. Median: $48 (938% 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 938% of the Medicare baseline (a markup of 838%). 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 - $50 | 39% |
| Blue Cross Blue Shield | $4 - $48 | 78% |
| Medicaid / KanCare | $4 | 78% |
| Blue Care Network Advantage | $5 | 98% |
| Medicare (plans) | $5 - $14 | 98% |
| Wellpath | $8 | 156% |
| Access Health | $10 | 195% |
| Aetna | $14 - $45 | 273% |
| Align Senior Care | $14 | 273% |
| Correctional Recovery | $14 | 273% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $16 | 313% |
| Oscar | $17 | 332% |
| Vitalcore | $19 | 371% |
| UnitedHealthcare | $20 - $50 | 391% |
| Molina Marketplace | $23 | 449% |
| Hospice Of Michigan | $31 | 605% |
| Nomi Health | $31 | 605% |
| Hap | $42 - $51 | 820% |
| Wc Accident Fund | $44 | 859% |
| Wc Advantage | $44 | 859% |
| Wc Aig | $44 | 859% |
| Wc Allied | $44 | 859% |
| Wc Amerisure | $44 | 859% |
| Wc Amtrust | $44 | 859% |
| Wc Asu Risk Mgt | $44 | 859% |
| Wc Berkley Admin | $44 | 859% |
| Wc Broadspire | $44 | 859% |
| Wc Bunch & Associates | $44 | 859% |
| Wc Ccmsi | $44 | 859% |
| Wc Emc Insurance Company | $44 | 859% |
| Wc Esis | $44 | 859% |
| Wc Fcci | $44 | 859% |
| Wc Federated | $44 | 859% |
| Wc Gallagher Bassett | $44 | 859% |
| Wc Genex Care For Ohio | $44 | 859% |
| Wc Guard Insurance Company | $44 | 859% |
| Wc Hartford | $44 | 859% |
| Wc Liberty Mutual | $44 | 859% |
| Wc Meijers | $44 | 859% |
| Wc Michigan | $44 | 859% |
| Wc Mitchell Frankenmuth | $44 | 859% |
| Wc Pma | $44 | 859% |
| Wc Sedgwick | $44 | 859% |
| Wc Sentry | $44 | 859% |
| Wc Travelers | $44 | 859% |
| Wc Tristar | $44 | 859% |
| Wc Walmart | $44 | 859% |
| Wc Zurich | $44 | 859% |
| Geha | $45 - $50 | 879% |
| Meritain | $45 | 879% |
| Asr Health Benefits | $47 | 918% |
| 1199 National Benefit Fund | $48 | 938% |
| Allied National Global Care | $48 | 938% |
| Asrm - Reliance Standard Life Insurance | $48 | 938% |
| Bcn Domestic | $48 | 938% |
| Blue Benefit Administrators Of Massachusetts | $48 | 938% |
| Blue Care Network | $48 | 938% |
| Blue Distinction Transplant | $48 | 938% |
| Blue Shield - Ca | $48 | 938% |
| Blue Shield - Id (Regence) | $48 | 938% |
| Blue Shield - Ny Highmark Northeastern | $48 | 938% |
| Blue Shield - Ny Highmark Western | $48 | 938% |
| Blue Shield - Pa (Highmark) | $48 | 938% |
| Blue Shield - Wa (Regence) | $48 | 938% |
| Christian Care Ministry | $48 | 938% |
| Dean Health | $48 | 938% |
| Fallon Health | $48 | 938% |
| Family Life Insurance Company | $48 | 938% |
| Ghc Scw | $48 | 938% |
| Group Pension Administrators | $48 | 938% |
| Health Choices | $48 - $50 | 938% |
| International Benefit Administrators | $48 | 938% |
| Kaiser Domestic | $48 | 938% |
| Lifetime Benefit Solutions | $48 | 938% |
| Manhattan Life | $48 | 938% |
| Medi Share | $48 | 938% |
| Multiplan | $48 | 938% |
| Mvp | $48 | 938% |
| Pai | $48 | 938% |
| Pan-American Life | $48 | 938% |
| Paramount Hmo | $48 | 938% |
| Phcs | $48 | 938% |
| Trinity Health Share | $48 | 938% |
| Cigna | $49 | 957% |
| Acclaim | $50 | 977% |
| Administrative Concepts | $50 | 977% |
| Allegeant | $50 | 977% |
| Allied Benefit Systems | $50 | 977% |
| Ameriben | $50 | 977% |
| American Family | $50 | 977% |
| American Healthcare Alliance | $50 | 977% |
| American Republic | $50 | 977% |
| Amerihealth | $50 | 977% |
| Aultcare | $50 | 977% |
| Automated Benefit Services | $50 | 977% |
| Auxiant | $50 | 977% |
| Benefit Administrative Systems,Llc | $50 | 977% |
| Boon Chapman | $50 | 977% |
| Cam Administrative Services | $50 | 977% |
| Caresource | $50 | 977% |
| Christian Brother Services | $50 | 977% |
| Christian Brothers Holy Cross | $50 | 977% |
| Claimchoice Adminstrators | $50 | 977% |
| Comprehensive Benefits | $50 | 977% |
| Consociate | $50 | 977% |
| Continental Life Insurance | $50 | 977% |
| Custom Benefit Administrators | $50 | 977% |
| Cypress Benefit Administrators | $50 | 977% |
| Employee Benefit Concepts | $50 | 977% |
| Employee Benefit Management | $50 | 977% |
| Enterprise Group Planning | $50 | 977% |
| Forest County Potawatomi | $50 | 977% |
| Freedom Life Insurance Company | $50 | 977% |
| Group Administrators | $50 | 977% |
| Group Marketing Services | $50 | 977% |
| Guardian | $50 | 977% |
| Health America | $50 | 977% |
| Health Smart | $50 | 977% |
| Healthez | $50 | 977% |
| Healthgram | $50 | 977% |
| Healthscope | $50 | 977% |
| Humana | $50 | 977% |
| Insight | $50 | 977% |
| Intercare | $50 | 977% |
| Jfp Benefit Management | $50 | 977% |
| Jp Farley Corporation | $50 | 977% |
| Key Benefit Administrator | $50 | 977% |
| Liberty Union Life Assurance Co | $50 | 977% |
| Lucent Health | $50 | 977% |
| Luminare Health | $50 | 977% |
| Luminare Health (Detroit) | $50 | 977% |
| Medben | $50 | 977% |
| Medcost | $50 | 977% |
| Medical Mutual | $50 | 977% |
| Mutual Health Services | $50 | 977% |
| Mutual Of Omaha | $50 | 977% |
| Ncas | $50 | 977% |
| Nippon Life Ins | $50 | 977% |
| Nova | $50 | 977% |
| Painters Union Insurance Fund | $50 | 977% |
| Physicians Mutual | $50 | 977% |
| Plumbers Local 98 Insurance Fund | $50 | 977% |
| Prairie States | $50 | 977% |
| Primary Physician Care | $50 | 977% |
| Priority Health | $50 | 977% |
| Professional Benefit Administrators | $50 | 977% |
| Secureone Preferred United Plans | $50 | 977% |
| The Loomis Company | $50 | 977% |
| Trustmark Small Business Benefits | $50 | 977% |
| Unicare | $50 | 977% |
| Unified Group Services | $50 | 977% |
| Us Health And Life | $50 | 977% |
| Valenz | $50 | 977% |
| Varipro | $50 - $51 | 977% |
| Western & Southern Financial Group | $50 | 977% |
| Wps | $50 | 977% |
| First Health | $51 | 996% |