CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Adventist Health St Helena

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $5
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Adventist Health St Helena is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 0.98x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $27 (527%)
Insurance Median: $5 (98%)
Cash: $27 (527% of Medicare)
Ins. Median: $5 (98% 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.

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 Shield Behav Hlth $2 - $81 39%
Blue Shield Epn-All Other Plans $2 - $85 39%
Blue Shield Non-Epn $2 - $84 39%
Phcs-All Plans $2 - $100 39%
UnitedHealthcare $2 - $115 39%
Western Growers-All Plans $2 - $96 39%
Beech Street-All Plans $3 - $136 59%
Choicecare-All Plans $3 - $127 59%
Cigna $3 - $145 59%
Interplan-All Plans $3 - $118 59%
Galaxy Network-All Plans $4 - $163 78%
Health Management Network-All Plans $4 - $154 78%
Kaiser-All Other Plans $4 - $148 78%
Three Rivers-All Plans $4 - $163 78%
Va Medi-Cal $4 - $6 78%
Blue Shield Bh Mcr Adv $5 98%
Blue Shield Mcr Adv $5 98%
Kaiser Mcr Adv $5 98%
Tricare $5 98%
Va Mcr - All Other Plans $5 98%
Ah Employee Health Plan - All Plans $9 176%
Healthnet-All Plans $9 176%
Aetna $30 586%
Blue Cross Blue Shield $44 - $59 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals