CMS Price Transparency Data
Blood test, creatinine (kidney)
Facility: Mount Carmel St Ann's
Billing Code: 82565 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82565
- Insurance Median: $14
- Cash Discount Price: $4,816
- vs. Medicare Baseline: 2.73x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mount Carmel St Ann's is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,816. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.73x the Medicare baseline. Located in 500 South Cleveland Avenue, Westerville, OH.
Cash / Self-Pay
$4,816
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: $4,816 (94063%)
Insurance Median: $14 (273%)
Cash: $4,816 (94063% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $4 - $353 | 78% |
| Aetna | $5 - $3,563 | 98% |
| Blue Benefit Administrators Of Massachusetts | $5 - $1,255 | 98% |
| Blue Care Network | $5 - $1,255 | 98% |
| Blue Cross Blue Shield | $5 - $1,255 | 98% |
| Blue Distinction Transplant | $5 - $1,255 | 98% |
| Blue Shield - Ca | $5 - $1,255 | 98% |
| Blue Shield - Id (Regence) | $5 - $1,255 | 98% |
| Blue Shield - Ny Highmark Northeastern | $5 - $1,255 | 98% |
| Blue Shield - Ny Highmark Western | $5 - $1,255 | 98% |
| Blue Shield - Pa (Highmark) | $5 - $1,255 | 98% |
| Blue Shield - Wa (Regence) | $5 - $1,255 | 98% |
| Hospice Mount Carmel | $5 - $336 | 98% |
| Oscar | $5 - $555 | 98% |
| Rural Carrier Health Benefit Plan | $5 - $3,563 | 98% |
| The Health Plan | $5 - $343 | 98% |
| UnitedHealthcare | $5 - $7,902 | 98% |
| Medical Mutual | $9 - $1,197 | 176% |
| Enterprise Group Planning | $10 - $649 | 195% |
| Custom Design Benefits | $11 - $703 | 215% |
| Quality Care Partners | $12 - $760 | 234% |
| Access Health | $14 | 273% |
| Acclaim | $14 | 273% |
| Administrative Concepts | $14 | 273% |
| Allegeant | $14 | 273% |
| Allied Benefit Systems | $14 | 273% |
| American Family | $14 | 273% |
| American Healthcare Alliance | $14 | 273% |
| American National | $14 | 273% |
| American Republic | $14 | 273% |
| Amerihealth | $14 | 273% |
| Aultcare | $14 | 273% |
| Automated Benefit Services | $14 | 273% |
| Auxiant | $14 | 273% |
| Benefit Administrative Systems,Llc | $14 | 273% |
| Boon Chapman | $14 | 273% |
| Cam Administrative Services | $14 | 273% |
| Christian Brother Services | $14 | 273% |
| Christian Brothers Holy Cross | $14 | 273% |
| Claimchoice Adminstrators | $14 | 273% |
| Comprehensive Benefits | $14 | 273% |
| Continental Life Insurance | $14 | 273% |
| Coventry | $14 | 273% |
| Custom Benefit Administrators | $14 | 273% |
| Cypress Benefit Administrators | $14 | 273% |
| Employee Benefit Concepts | $14 | 273% |
| Employee Benefit Management | $14 | 273% |
| Forest County Potawatomi | $14 | 273% |
| Freedom Life Insurance Company | $14 | 273% |
| Geha | $14 - $7,902 | 273% |
| Gravie Admin Services | $14 | 273% |
| Group Administrators | $14 | 273% |
| Group Marketing Services | $14 | 273% |
| Group Pension Administrators | $14 | 273% |
| Guardian | $14 | 273% |
| Health America | $14 | 273% |
| Health Choices | $14 | 273% |
| Healthcare Management Admin | $14 | 273% |
| Healthez | $14 | 273% |
| Insight | $14 | 273% |
| Intercare | $14 | 273% |
| Jfp Benefit Management | $14 | 273% |
| Jp Farley Corporation | $14 | 273% |
| Key Benefit Administrator | $14 | 273% |
| Liberty Union Life Assurance Co | $14 | 273% |
| Lucent Health | $14 | 273% |
| Luminare Health | $14 | 273% |
| Magnacare | $14 | 273% |
| Medcost | $14 | 273% |
| Meritain | $14 | 273% |
| Mutual Health Services | $14 | 273% |
| Mutual Of Omaha | $14 | 273% |
| Ncas | $14 | 273% |
| Nippon Life Ins | $14 | 273% |
| Nova | $14 | 273% |
| Painters Union Insurance Fund | $14 | 273% |
| Physicians Mutual | $14 | 273% |
| Plumbers Local 98 Insurance Fund | $14 | 273% |
| Prairie States | $14 | 273% |
| Preferred One | $14 | 273% |
| Primary Physician Care | $14 | 273% |
| Professional Benefit Administrators | $14 | 273% |
| Secureone Preferred United Plans | $14 | 273% |
| Siho Insurance Services | $14 | 273% |
| Sisco Benefits | $14 | 273% |
| The Loomis Company | $14 | 273% |
| Trustmark Small Business Benefits | $14 | 273% |
| U Of M Health Plan | $14 | 273% |
| Unicare | $14 | 273% |
| Unified Group Services | $14 | 273% |
| Us Health And Life | $14 | 273% |
| Valenz | $14 | 273% |
| Varipro | $14 | 273% |
| Webtpa | $14 | 273% |
| Western & Southern Financial Group | $14 - $1,197 | 273% |
| Wps | $14 | 273% |
| First Health | $16 | 313% |
| Humana | $16 - $31 | 313% |
| Paramount Hmo | $16 | 313% |
| Consociate | $19 | 371% |
| Health Ohio Network | $19 | 371% |
| Medben | $19 - $23 | 371% |
| American Postal Workers Secondary | $21 - $2,921 | 410% |
| Cigna | $21 - $2,921 | 410% |
| Health Partners | $21 - $2,921 | 410% |
| Healthgram | $21 - $2,921 | 410% |
| Mvp | $21 - $2,921 | 410% |
| Priority Health | $21 - $2,921 | 410% |
| Caresource | $23 | 449% |
| Healthlink Inc | $23 | 449% |
| Medical Benefits Mutual | $23 | 449% |
| Ohio Health Choice | $23 | 449% |
| Ohio Ppo Connect | $23 | 449% |
| Ameriben | $25 | 488% |
| Luminare Health (Detroit) | $25 | 488% |
| Medi Share | $25 | 488% |
| Multiplan | $25 | 488% |
| Ohiohealthy | $25 | 488% |
| Osu Not Independent Choice | $25 | 488% |
| Phcs | $25 | 488% |
| Philadelphia American Life Insurance | $25 | 488% |
| Twin Valley Psychiatric | $25 | 488% |
| Health Smart | $26 | 508% |
| Bccp | $31 | 605% |
| Medicaid / KanCare | $31 | 605% |
| Optima Health | $31 | 605% |
| Crime Victim Assistance | $632 | 12344% |
| Ohio Safe Program | $632 | 12344% |