CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Fort Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $29
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Fort Memorial Hospital is $29. 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 5.66x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $29 (566%)
Cash: $28 (547% of Medicare)
Ins. Median: $29 (566% 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 566% of the Medicare baseline (a markup of 466%). 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 - $6 39%
Dean Health Plan $2 - $45 39%
Managed Health Services $2 39%
Medicaid / KanCare $2 39%
Quartz $2 - $29 39%
UnitedHealthcare $2 - $9 39%
Molina $4 78%
Humana $5 98%
Centivo $6 117%
Veteran Evaluation Services $6 117%
Aetna $28 - $79 547%
Group Health Cooperative $45 - $250 879%
Alliance $50 - $75 977%
Mercycare $52 - $78 1016%
Trilogy $61 - $92 1191%
Cigna $66 - $100 1289%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 Sherman Ave E, Fort Atkinson, WI 53538
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals