CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Wooster Community Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $28
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Wooster Community Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.47x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $37 (723%)
Insurance Median: $28 (547%)
Cash: $37 (723% of Medicare)
Ins. Median: $28 (547% 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 547% of the Medicare baseline (a markup of 447%). 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 $4 - $11 78%
Buckeye Mcare $5 98%
Caresource Mcr Adv $5 98%
Humana $5 - $35 98%
Med Mutual Of Oh Mcr $5 98%
Molina Mcr $5 98%
Summacare Mcr $5 98%
The Health Plan Mcr Adv $5 98%
Tricare $5 98%
UnitedHealthcare $5 - $35 98%
Valor Hp Mcr-All Plans $5 98%
Caresource Exch - All Other Plans $7 137%
Magnipower-All Plans $7 137%
Molina Marketplace - All Other Plans $9 176%
Buckeye Mcaid-All Other Plans $10 195%
Caresource Mcaid $10 195%
Clarity Health - All Plans $10 195%
Molina Mcaid $10 195%
Aetna $11 - $37 215%
Amerihealth Mcaid-All Plans $11 215%
Aultcare/Primecare Mcr Adv $18 352%
Cerco-All Plans $26 508%
Aultcare Wayne County $28 547%
Aultcare/Primetime Exch $28 547%
Rayco-All Plans $28 547%
Christian Health Ministries-All Plans $30 586%
Cigna $30 586%
Health Ohio Network Employer $30 586%
Wayne County-All Plans $30 586%
Healthsmart Accel $31 605%
Summacare Preferred Choice $31 605%
Health Ohio Network Ppo-All Other Plans $32 625%
Healthsmart Complete Ppo-All Other Plans $32 625%
Med Mutual Of Oh Exchange $32 625%
Med Mutual Of Oh Supermed $32 625%
Med Mutual Of Oh Trad-All Other Plans $32 625%
Ohio Health Choice Supp $32 625%
Ohio Health Group Hlthy - All Other Plans $32 625%
Health Plan Of Upper Ohio-All Plans $33 645%
Ohio Health Group Pref $33 645%
The Health Plan Comm - All Other Plans $33 645%
Aultcare/Primetime-All Other Plans $34 664%
Healthsmart Ppo $34 664%
Healthsmart Hpo $35 684%
Ohio Health Choice-All Other Plans $35 684%
Osu-All Plans $35 684%
Summacare-All Other Plans $35 684%
Beech Street-All Plans $36 703%
Central Benefits-All Plans $36 703%
First Health-All Plans $36 703%
Flora-All Plans $36 703%
Phcs-All Plans $36 703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals