CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $67
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 13.09x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Carilion Stonewall Jackson Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 13.09x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $37 (723%)
Insurance Median: $67 (1309%)
Cash: $37 (723% of Medicare)
Ins. Median: $67 (1309% 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 1309% of the Medicare baseline (a markup of 1209%). 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
Sentara Health Plan $5 - $65 98%
Blue Cross Blue Shield $5 98%
Abh of VA (Formerly Coventry) $6 117%
Abh of Wva (Formerly Coventry) $6 117%
Humana $6 117%
UnitedHealthcare $6 - $86 117%
Aetna $53 - $70 1035%
Gateway - Tier 3 $58 1133%
Vhn - Ultra $65 1270%
Connecticare $74 1445%
Cigna $84 1641%
Vhn - Plus $84 1641%
Gateway - Tier 2 $84 1641%
Integrated Health Plan $89 1738%
Vhn $89 1738%
Vhn - Link $94 1836%
Beech Street $97 1895%
Gateway - Tier 1 $100 1953%
Vhn - Secondary Payors $100 1953%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals