CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Johnson County Community Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $12
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Johnson County Community Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.34x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$9

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $9 (176%)
Insurance Median: $12 (234%)
Cash: $9 (176% of Medicare)
Ins. Median: $12 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Blue Cross Blue Shield $2 - $29 39%
UnitedHealthcare $5 - $11 98%
Aetna $6 - $25 117%
Molina Healthcare $6 - $12 117%
Optima Health $6 117%
Amerigroup $11 215%
Humana $11 215%
Managed Medicaire $11 215%
Medicare (plans) $11 215%
Sentara Health $11 - $13 215%
United Mine Workers Of America $11 215%
Wellcare $11 215%
Ambetter / Centene $12 234%
Cigna $12 - $20 234%
Devoted Health Plan $12 234%
Nhc Advantage $12 234%
Medcost $14 273%
First Health Coventry $29 566%
Seven Corners, Inc. $39 762%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals