CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Mon Health Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $23
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mon Health Medical Center is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.49x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $15 (293%)
Insurance Median: $23 (449%)
Cash: $15 (293% of Medicare)
Ins. Median: $23 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
Zelis_Other_Plan $4 78%
Aetna $5 - $8 98%
Blue Cross Blue Shield $5 - $25 98%
Health_South_Mountain_View_Plan $5 98%
Humana $5 - $27 98%
Medicare (plans) $5 98%
Paramount_Elite_Plan $5 98%
Uhc_Va_Plan $5 98%
Zelis_Group_Health_Plan $5 98%
The_Health_Plan_Peia_Plan $6 117%
Unison_Plan $6 117%
Gateway_Health_Plan $7 137%
Seven_Corners_Plan $10 195%
Maryland_Physicians_Care_Plan $21 410%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $24 469%
The_Health_Plan_Plan $26 508%
Acpn_Plan $27 527%
Cigna $27 527%
Mon_County_Commission_Plan $27 527%
Uhc_Plan $27 527%
Health_Payors_Organization_Plan $28 547%
Uhc_Options_Ppo_Plan $28 547%
Geha_Plan $29 566%
Multiplan_Phcs_Plan $29 566%
Mutual_Of_Omaha_Plan $29 566%
Three_Rivers_Plan $29 566%
Uhc_Onenet_Ppo_Plan $29 566%
Upmc__Plan $29 566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals