CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Galion Community Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $38
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 7.42x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Galion Community Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 7.42x the Medicare baseline. Located in 269 Portland Way South, Galion, OH.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $43 (840%)
Insurance Median: $38 (742%)
Cash: $43 (840% of Medicare)
Ins. Median: $38 (742% 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 742% of the Medicare baseline (a markup of 642%). 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 $17 - $4,224 332%
Blue Cross Blue Shield $17 - $4,142 332%
Buckeye $17 - $4,142 332%
Humana $17 - $4,142 332%
Medicare (plans) $17 - $4,142 332%
Molina $17 - $5,629 332%
Mount_Carmel $17 - $4,142 332%
United_Healthcare $17 - $4,142 332%
Caresource $20 391%
Medicaid / KanCare $20 391%
Ohiorise $20 391%
Amerihealth $21 410%
Medical_Mutual $40 - $4,224 781%
Cigna $44 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 269 Portland Way South, Galion, OH 44833
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals