CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Pioneer Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $47
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 9.18x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Pioneer Medical Center is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 9.18x the Medicare baseline. Located in 301 W 7Th Ave, Big Timber, MT.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $43 (840%)
Insurance Median: $47 (918%)
Cash: $43 (840% of Medicare)
Ins. Median: $47 (918% 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 918% of the Medicare baseline (a markup of 818%). 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
Blue Cross Blue Shield $22 - $48 430%
Health Info Net Mcr Adv $22 - $26 430%
Healtnet Federal-All Plans $22 - $26 430%
Humana $22 - $53 430%
Triwest Va Pccc-All Plans $22 - $26 430%
UnitedHealthcare $22 - $55 430%
Rocky Mountain Health Network-All Plans $34 - $41 664%
Allegiance Provider-All Plans $42 - $49 820%
Mountain Health Co-Op Hpn $43 - $51 840%
6 Degrees Health-All Plans $47 - $55 918%
Americas Choice-All Plans $47 - $55 918%
City Of Billings-All Plans $47 - $55 918%
Community Health Ntwk-All Plans $47 - $55 918%
Ebms Select Care Network-All Plans $47 - $55 918%
Fedmed Network-All Plans $47 - $55 918%
First Choice Big Sky-All Plans $47 - $55 918%
First Health-All Plans $47 - $55 918%
Interwest Ppo $47 - $55 918%
Mountain Health Co-Op-All Other Plans $47 - $55 918%
Pacific Source-All Plans $47 - $55 918%
Pacific Steel & Recycling-All Plans $47 - $55 918%
Three Rivers-All Plans $47 - $55 918%
Health Info Net Peak/Equity $48 - $56 938%
Health Info Net Standard-All Other Plans $48 - $56 938%
Mountain Health Co-Op Ppo/Pos $48 - $57 938%
Interwest Health Traditional-All Other Plans $49 - $58 957%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 W 7Th Ave, Big Timber, MT 59011
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals