CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Mercy Hospital - Cassville

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $67
Cash Discount Price: $55
vs. Medicare Baseline: 13.09x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mercy Hospital - Cassville is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 13.09x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $55 (1074%)

Insurance Median: $67 (1309%)

Cash: $55 (1074% of Medicare)

Ins. Median: $67 (1309% 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 1309% of the Medicare baseline (a markup of 1209%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$5 - $75	98%
Blue Cross Blue Shield	$5 - $81	98%
Humana	$5 - $71	98%
Medicaid / KanCare	$5 - $44	98%
Medicare (plans)	$5 - $36	98%
UnitedHealthcare	$7 - $80	137%
Dept Of Veteran Affairs Contracted [320106]	$29	566%
Tricare	$34	664%
Cherokee Nation Health Serv Contracted [320066]	$35	684%
Cigna	$35 - $80	684%
Cross Timbers Hospice [20098]	$35	684%
Elara Caring Aspire Hospice [20433]	$35	684%
Globalhealth Contracted [320145]	$35	684%
Halo Hcr Inc Hospice Contracted [320432]	$35	684%
Halo Hcr Inc Hospice [20432]	$35	684%
Healthscope Contracted [320182]	$35	684%
Indian Health Service Contracted [320198]	$35	684%
Kindful Hospice Contracted [320434]	$35	684%
Kindful Hospice [20434]	$35	684%
Medical Associates Health Contracted [320444]	$35	684%
Mercy Hospice Okc [20252]	$35	684%
Mercy Mgd Behavioral Health Contracted [320259]	$35	684%
Pace Of The Ozarks Contracted [320518]	$35	684%
Provider Partners Health Plans Contracted [320450]	$35	684%
Qual Choice Contracted [320325]	$35	684%
Administrative Payor Contracted [320005]	$38	742%
Centivo Contracted [320505]	$43	840%
Ambetter / Centene	$44	859%
Home State Health Plan Contracted [320187]	$44	859%
Novasys Contracted [320285]	$44	859%
Healthlink Contracted [320179]	$55 - $76	1074%
Preferred Health Plan Contracted [320522]	$55	1074%
Health Systems Inc Contracted [320174]	$67	1309%
Insurance System Inc Contracted [320465]	$67	1309%
Point C Contracted [320238]	$67 - $76	1309%
Point C [20238]	$67	1309%
United Medical Resources Contracted [320454]	$67 - $71	1309%
Workers Comp [20426]	$67 - $76	1309%
Municipal Health Plan Contracted [320271]	$68	1328%
Medica Contracted [320239]	$75	1465%
90 Degree Benefits Contracted [320436]	$76	1484%
Aither Health Contracted [320449]	$76	1484%
American Healthcare Alliance Contracted [320020]	$76	1484%
Auxiant Contracted [320462]	$76	1484%
Benefit Management Contracted [320052]	$76	1484%
Ebms Contracted [320493]	$76	1484%
Edison Health Solutions Contracted [320502]	$76	1484%
Evolutions Health Care Contracted [320124]	$76	1484%
Imagine 360 Contracted [320494]	$76	1484%
Mercy Benefit Admin Contracted [320251]	$76	1484%
Reflect Health Contracted [320492]	$76	1484%
Show-Me Health Administrators Contracted [320483]	$76	1484%
Usa Managed Care Org Contracted [320429]	$76	1484%
Yuzu Health Contracted [320521]	$76	1484%
First Health Contracted [320128]	$80	1563%
Multiplan Contracted [320270]	$80	1563%
Private Health Care Systems Contracted [320320]	$80	1563%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $55.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital - Cassville is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.