CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Mercy Hospital Carthage

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $44
  • Cash Discount Price: $52
  • vs. Medicare Baseline: 8.59x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mercy Hospital Carthage is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.59x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$52

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $52 (1016%)
Insurance Median: $44 (859%)
Cash: $52 (1016% of Medicare)
Ins. Median: $44 (859% 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 859% of the Medicare baseline (a markup of 759%). 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
Aetna $5 - $71 98%
Blue Cross Blue Shield $5 - $22 98%
Humana $5 - $24 98%
Medicaid / KanCare $5 - $44 98%
Medicare (plans) $5 - $24 98%
United Medical Resources Contracted [320454] $7 - $72 137%
UnitedHealthcare $7 - $70 137%
Cherokee Nation Health Serv Contracted [320066] $22 430%
Cigna $22 - $72 430%
Cross Timbers Hospice [20098] $22 430%
Dept Of Veteran Affairs Contracted [320106] $22 430%
Elara Caring Aspire Hospice [20433] $22 430%
Globalhealth Contracted [320145] $22 430%
Halo Hcr Inc Hospice Contracted [320432] $22 430%
Halo Hcr Inc Hospice [20432] $22 430%
Indian Health Service Contracted [320198] $22 430%
Kindful Hospice Contracted [320434] $22 430%
Kindful Hospice [20434] $22 430%
Medical Associates Health Contracted [320444] $22 430%
Mercy Hospice Okc [20252] $22 430%
Mercy Mgd Behavioral Health Contracted [320259] $22 430%
Pace Of The Ozarks Contracted [320518] $22 430%
Provider Partners Health Plans Contracted [320450] $22 430%
Qual Choice Contracted [320325] $22 430%
Tricare $22 430%
Point C Contracted [320238] $28 - $72 547%
Health Systems Inc Contracted [320174] $34 664%
Insurance System Inc Contracted [320465] $34 664%
Administrative Payor Contracted [320005] $36 703%
Centivo Contracted [320505] $37 723%
Healthscope Contracted [320182] $42 820%
Ambetter / Centene $44 859%
Home State Health Plan Contracted [320187] $44 859%
Novasys Contracted [320285] $44 859%
Benefit Management Contracted [320052] $48 - $70 938%
Auxiant Contracted [320462] $52 - $68 1016%
Healthlink Contracted [320179] $52 - $74 1016%
Preferred Health Plan Contracted [320522] $52 1016%
Workers Comp [20426] $64 - $80 1250%
90 Degree Benefits Contracted [320436] $68 1328%
Aither Health Contracted [320449] $68 1328%
Ebms Contracted [320493] $68 1328%
Edison Health Solutions Contracted [320502] $68 1328%
Imagine 360 Contracted [320494] $68 1328%
Mercy Benefit Admin Contracted [320251] $68 - $72 1328%
Reflect Health Contracted [320492] $68 1328%
Show-Me Health Administrators Contracted [320483] $68 1328%
Yuzu Health Contracted [320521] $68 1328%
Medica Contracted [320239] $69 1348%
Evolutions Health Care Contracted [320124] $70 1367%
First Health Contracted [320128] $70 1367%
Multiplan Contracted [320270] $70 1367%
Private Health Care Systems Contracted [320320] $70 1367%
American Healthcare Alliance Contracted [320020] $72 1406%
Ppo Plus Contracted [320310] $72 1406%
Usa Managed Care Org Contracted [320429] $72 1406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3125 Dr Russell Smith Way, Carthage, MO 64836
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals