CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Licking Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $52
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 10.16x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Licking Memorial Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 10.16x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $72 (1406%)
Insurance Median: $52 (1016%)
Cash: $72 (1406% of Medicare)
Ins. Median: $52 (1016% 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 1016% of the Medicare baseline (a markup of 916%). 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 - $53 98%
Blue Cross Blue Shield $5 - $62 98%
Champva [500001] $5 98%
Cigna $5 - $65 98%
Humana $5 - $70 98%
Medicare (plans) $5 98%
Tricare $5 98%
UnitedHealthcare $5 - $61 98%
Veterans Administration [100068] $5 98%
Wellcare By Allwell [450104] $5 98%
Molina Marketplace [100106] $8 156%
Medical Mutual [100114] $40 - $60 781%
Medben [700068] $51 - $71 996%
Allied Benefit Systems [100015] $52 1016%
Geha [100039] $52 1016%
Gravie Administrative Services [100165] $52 1016%
Meritain [100063] $52 1016%
Optima [700069] $52 1016%
Trustmark Small Business Benefits [100263] $52 1016%
Webtpa [100127] $52 1016%
Benicomp [70090] $54 1055%
Consociate Health 6 Degrees [100059] $58 1133%
Consociate Health [100029] $58 1133%
Healthscope [100157] $61 1191%
Surest [100016] $61 1191%
United Medical Resources [700071] $61 1191%
American Postal Workers [100089] $65 1270%
Antidote Health Plan Of Ohio [70006803] $65 1270%
Coresource [100002] $65 - $72 1270%
Great West Life [700064] $65 1270%
National Association Of Letter Carriers [100067] $65 1270%
Ohio Healthy Luminare Health [100264] $65 1270%
Ohio Healthy [100255] $65 1270%
Ohio Ppo Connect [70006801] $65 1270%
Osu Prime Care [100254] $65 1270%
Quality Care Partners [70006802] $65 1270%
The Health Plan [100261] $65 1270%
Wellfleet Group, Llc [100164] $65 1270%
Coventry [100010] $67 1309%
Pan American Life [700070] $67 1309%
Ohio Health Choice [100109] $69 1348%
Administrative Concepts [100006] $70 1367%
Carefactor [100087] $70 1367%
Philadelphia American Life [100260] $70 - $72 1367%
Reliance Standard-Asrm [100258] $70 1367%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals