CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Hermann Area District Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $33
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 6.45x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Hermann Area District Hospital is $33. 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 6.45x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $33 (645%)
Cash: $35 (684% of Medicare)
Ins. Median: $33 (645% 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 645% of the Medicare baseline (a markup of 545%). 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
Coventry - All Plans $3 59%
UnitedHealthcare $8 - $24 156%
Cigna $23 449%
Tricare $23 449%
Choicecare Mcr Adv- All Plans $24 469%
American Hlth Mcr Adv- All Plans $25 488%
Blue Cross Blue Shield $25 - $47 488%
Humana $25 488%
Aetna $26 - $55 508%
Wellcare Mcr Adv - All Plans $26 508%
Harmony Hp Mcaid- All Plans $33 645%
Healthcare Usa Mcaid- All Plans $37 723%
Healthlink Hmo $37 723%
Ambetter / Centene $40 781%
Healthlink Ppo - All Other Plans $43 840%
Multiplan/Phcs - All Plans $43 840%
Comp Results - All Plans $52 1016%
Three Rivers - All Plans $52 1016%
Care Partners Mcaid- All Plans $58 1133%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals