CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Hillcrest Hospital Pryor

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $94
Cash Discount Price: $43
vs. Medicare Baseline: 18.36x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Hillcrest Hospital Pryor is $94. 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 18.36x the Medicare baseline. Located in 111 North Bailey Street, Pryor, OK.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

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: $94 (1836%)

Cash: $43 (840% of Medicare)

Ins. Median: $94 (1836% 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 1836% of the Medicare baseline (a markup of 1736%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Black Lung [6055]	$36	703%
Healthcare Highways [2210]	$36 - $94	703%
Hooray Health [8000]	$36	703%
Lucent Health [6000]	$36	703%
Oncology Patient Assistance Programs [2295]	$36	703%
Oscar Insurance Company [7005]	$36	703%
Osma Health Network [2345]	$36	703%
Healthscope Benefits [2290]	$44	859%
UnitedHealthcare	$44	859%
The Kempton Group Administrators [2905]	$65	1270%
Beacon Health Options Behavioral Health [2890]	$89	1738%
Global Health [1430]	$89	1738%
Resource One Administrators [2815]	$94	1836%
Universal Fidelity [2085]	$94	1836%
Web Tpa [2115]	$94	1836%
First Health [1375]	$106	2070%
Medica [2910]	$106	2070%
Multiplan [1680]	$106	2070%
Cigna	$119	2324%
Healthpartners [1500]	$119	2324%
Pba [1775]	$119	2324%
Pending Ssi [1616]	$144	2813%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $43.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hillcrest Hospital Pryor is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.