CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Clarion Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $10
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Clarion Hospital is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 1.95x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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: $28 (547%)
Insurance Median: $10 (195%)
Cash: $28 (547% of Medicare)
Ins. Median: $10 (195% 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.

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
Upmc $4 - $25 78%
Aetna $5 - $44 98%
Amerihealth $5 - $7 98%
Cigna $5 - $25 98%
Devoted Health Plan $5 - $20 98%
Gateway $5 - $18 98%
Geisinger $5 - $6 98%
Highmark $5 - $17 98%
Highmark Community Blue $5 98%
Martin'S Point - Usfhp $5 - $18 98%
Medicare (plans) $5 98%
Pa Health & Wellness $5 98%
The Health Plan $5 - $12 98%
Tricare $5 98%
UnitedHealthcare $5 98%
American Health Plan $6 117%
Jefferson Health Plan $6 117%
Medicaid / KanCare $6 117%
Highmark - Ind.& Managed Care $12 - $17 234%
Peak Health $12 - $35 234%
Devon $38 742%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals