CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Lodi Community Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $18
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 3.52x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Lodi Community Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.52x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.
Cash / Self-Pay
$22

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $22 (430%)
Insurance Median: $18 (352%)
Cash: $22 (430% of Medicare)
Ins. Median: $18 (352% 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 352% of the Medicare baseline (a markup of 252%). 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 $5 - $25 98%
Mmo $5 - $18 98%
UnitedHealthcare $5 - $21 98%
Humana $10 195%
Oscar $10 - $13 195%
Summacare $10 - $21 195%
United $10 - $24 195%
Aetna $12 - $34 234%
Buckeye $14 273%
Caresource $14 273%
The Health Plan $14 - $27 273%
Amish Community Aid Plan $15 - $17 293%
Molina $15 293%
Amerihealth $16 313%
Aultcare $17 332%
Ohcp $17 332%
Omas $17 332%
Ohio Healthy $18 352%
Php $20 391%
Phphi $20 391%
Upmc $20 391%
Cigna $22 430%
Cc Ehp $23 449%
Gms $24 469%
Medical Benefit Corp $24 469%
Consociate Health $26 508%
Frontpath $31 605%
Managed Care Services $31 605%
Multiplan $31 605%
Tertiary Care Network $31 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 Elyria Street, Lodi, OH 44254
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals