CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Southwest General Health Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $29
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Southwest General Health Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.66x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $41 (801%)
Insurance Median: $29 (566%)
Cash: $41 (801% of Medicare)
Ins. Median: $29 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Medical Mutual $2 39%
Medical Mutual-Ohio $2 39%
Buckeye $7 - $57 137%
Molina $7 - $57 137%
Cigna $12 234%
Healthsmart $17 332%
Health Design Plus $20 391%
Humana $21 - $57 410%
Clarity Health $22 430%
Healthspan $22 430%
Healthsmart Preferred $24 469%
Ohio Health Choice Plus $26 508%
Aetna $29 566%
Summacare $29 566%
UnitedHealthcare $29 - $57 566%
Coventry $37 723%
First Health $37 723%
Ohio Health Choice $42 820%
Private Healthare Systems $43 840%
Amerihealth Caritas $57 1113%
Blue Cross Blue Shield $57 1113%
Caresource $57 1113%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18697 Bagley Road, Middleburg Heights, OH 44130
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals