CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Adena Pike Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $23
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Adena Pike Medical Center is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.49x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $15 (293%)
Insurance Median: $23 (449%)
Cash: $15 (293% of Medicare)
Ins. Median: $23 (449% 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 449% of the Medicare baseline (a markup of 349%). 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 $6 - $37 117%
Blue Cross Blue Shield $6 - $32 117%
Buckeye Community Health Plan $6 - $9 117%
Care Source $6 - $9 117%
Humana $6 - $35 117%
Medical Mutual Of Ohio $6 - $24 117%
Medigold $6 - $9 117%
Molina $6 - $9 117%
Gateway Health $8 - $12 156%
Molina Marketplace $10 - $15 195%
Care Source Just4Me $11 - $16 215%
Sidecar Health $16 - $25 313%
Ohio Ppo Connect $17 - $26 332%
The Health Plan $17 - $26 332%
Cigna $18 - $27 352%
Medical Mutual Of Ohio Supermed $18 - $28 352%
First Health $19 - $37 371%
Ohio Health Choice $19 - $30 371%
Healthsmart $23 - $35 449%
Integrated Health Plan $23 - $35 449%
Multiplan/Private Healthcare Systems $23 - $35 449%
Three Rivers Network $23 - $35 449%
UnitedHealthcare $80 1563%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals