CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $30
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 5.86x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mercy Hospital Tishomingo Inc is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.86x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $39 (762%)
Insurance Median: $30 (586%)
Cash: $39 (762% of Medicare)
Ins. Median: $30 (586% 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 586% of the Medicare baseline (a markup of 486%). 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 - $40 98%
Humana $5 - $48 98%
Medicaid / KanCare $5 - $18 98%
Health Choice Contracted [320166] $7 137%
Blue Cross Blue Shield $16 - $29 313%
Ambetter / Centene $18 352%
Home State Health Plan Contracted [320187] $18 352%
Novasys Contracted [320285] $18 352%
Webtpa Contracted [320417] $25 488%
Medicare (plans) $28 - $38 547%
Cherokee Nation Health Serv Contracted [320066] $29 566%
Cross Timbers Hospice [20098] $29 566%
Dept Of Veteran Affairs Contracted [320106] $29 566%
Elara Caring Aspire Hospice Contracted [320433] $29 566%
Elara Caring Aspire Hospice [20433] $29 566%
Globalhealth Contracted [320145] $29 566%
Halo Hcr Inc Hospice Contracted [320432] $29 566%
Halo Hcr Inc Hospice [20432] $29 566%
Independent Health [20197] $29 566%
Indian Health Service Contracted [320198] $29 566%
Kindful Hospice Contracted [320434] $29 566%
Kindful Hospice [20434] $29 566%
Medical Associates Health [20444] $29 566%
Mercy Hospice Okc [20252] $29 566%
Provider Partners Health Plans Contracted [320450] $29 566%
Qual Choice Contracted [320325] $29 566%
Tribute Health Plan Mcr Contracted [320338] $29 566%
Tricare $29 566%
UnitedHealthcare $29 - $47 566%
Cigna $30 - $45 586%
Aither Health Contracted [320449] $36 - $51 703%
Mercy Benefit Admin Contracted [320251] $36 - $51 703%
Quik Trip Contracted [320447] $36 703%
Show-Me Health Administrators Contracted [320483] $36 703%
Medica Contracted [320239] $38 742%
First Health Contracted [320128] $40 781%
Osma Health Contracted [320292] $42 820%
Benefit Management Contracted [320052] $45 - $54 879%
Healthcare Highways Plus Contracted [320175] $45 879%
Private Health Care Systems Contracted [320320] $45 - $48 879%
United Medical Resources Contracted [320454] $47 918%
Multiplan Contracted [320270] $48 - $54 938%
Auxiant Contracted [320462] $51 996%
Ebms Contracted [320493] $51 996%
Healthlink Contracted [320179] $51 996%
Imagine 360 Contracted [320494] $51 996%
Preferred Community Choice Contracted [320311] $51 996%
Reflect Health Contracted [320492] $51 996%
Yuzu Health Contracted [320521] $51 996%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals