CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: SSM Health St. Mary's Hospital - Jefferson City

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $14
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at SSM Health St. Mary's Hospital - Jefferson City is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.73x the Medicare baseline. Located in 2505 Mission Drive, Jefferson City, MO.
Cash / Self-Pay
$22

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $22 (430%)
Insurance Median: $14 (273%)
Cash: $22 (430% of Medicare)
Ins. Median: $14 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Ambetter / Centene $5 98%
Blue Cross Blue Shield $5 - $32 98%
Essence $5 98%
Humana $5 98%
UnitedHealthcare $5 98%
Centurion $7 137%
6 Degress Health $9 176%
Health Systems $9 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2505 Mission Drive, Jefferson City, MO 65109
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals