CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: St Josephs Community Hospital West Bend

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $38
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 7.42x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at St Josephs Community Hospital West Bend is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 7.42x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $32 (625%)
Insurance Median: $38 (742%)
Cash: $32 (625% of Medicare)
Ins. Median: $38 (742% 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 742% of the Medicare baseline (a markup of 642%). 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 - $67 98%
Allwell $5 98%
Blue Cross Blue Shield $5 - $26 98%
Care Wisconsin $5 98%
Community Care $5 98%
Health Partners $5 - $62 98%
Humana $5 98%
Icare $5 98%
Molina $5 98%
Network Health Plan $5 - $6 98%
Security Health Plan Secure Savers $5 98%
UnitedHealthcare $5 - $32 98%
Sheboygan Employers Health Network $6 117%
Centivo $13 - $32 254%
Chorus Community Health Plan $18 - $41 352%
Froedtert South $18 - $40 352%
Common Ground $25 - $58 488%
Health Payment Systems $26 - $78 508%
Trilogy $34 - $79 664%
Wisconsin Physician Services $34 - $77 664%
Americas Choice $37 - $84 723%
First Health Network $37 - $84 723%
Healtheos $37 - $84 723%
Multiplan/Private Healthcare Systems $37 - $84 723%
Hfn $38 - $86 742%
Ibsi Passport $38 - $86 742%
Cigna $40 - $91 781%
Healthsmart $40 - $91 781%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals