CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Sanford Vermillion Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $30
  • Cash Discount Price: $34
  • vs. Medicare Baseline: 5.86x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Sanford Vermillion Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.86x the Medicare baseline. Located in 20 South Plum Street, Vermillion, SD.
Cash / Self-Pay
$34

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: $34 (664%)
Insurance Median: $30 (586%)
Cash: $34 (664% 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
Sanford Health Plan Align $12 234%
Wellmark Sd $13 254%
Aetna $14 - $36 273%
Health Partners $14 - $32 273%
Medicare (plans) $14 273%
Primewest $14 273%
Ucare $14 - $37 273%
UnitedHealthcare $14 - $35 273%
Sanford Health Plan $17 - $22 332%
Security Health Plan $23 449%
Medica $35 - $37 684%
Wellmark $36 - $37 703%
First Choice Health Network $38 742%
Healthez $38 742%
Multiplan $38 742%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20 South Plum Street, Vermillion, SD 57069
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals