CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Sonoma Valley Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $30
  • Cash Discount Price: $99
  • vs. Medicare Baseline: 5.86x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Sonoma Valley Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.86x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$99

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $99 (1934%)
Insurance Median: $30 (586%)
Cash: $99 (1934% of Medicare)
Ins. Median: $30 (586% 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 586% of the Medicare baseline (a markup of 486%). 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.

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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 $5 - $141 98%
Bright Hlth/Brand New Day Mcr Adv $5 98%
Hospice Of Marin-All Plans $5 98%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $5 98%
St Joseph Heritage Hltcare Comm-All Other Plans $5 98%
Tricare $5 98%
Veterans Admin-All Plans $5 98%
Cdcr Prison-All Plans $6 117%
Medi-Cal $6 117%
Partnership Healthplan-All Plans $6 117%
Three Rivers (Trpn)-All Plans $6 117%
Bright Hlth/Brand New Day - All Other Plands $7 137%
Chp - Correctional Health Partners - All Plans $7 137%
Meritage Medical Network Op Only Mcare $7 137%
Meritage Medical Network Op Only-All Other Plans $7 137%
Wellpath - All Plans $7 137%
Aetna $9 176%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $9 176%
Canopy Health Solutions-All Other Plans $9 176%
First Health(Coventry)-All Plans $9 176%
Mcal Mgd Care (Php)-All Plans $10 195%
UnitedHealthcare $10 195%
Healthnet Hmo/Ppo-All Other Plans $49 957%
Blue Shield Ppo-All Plans $80 1563%
Kaiser-All Plans $92 1797%
Integrated Health Plan-All Plans $104 2031%
Champus-All Plans $113 2207%
Cigna $113 2207%
Networks By Design - All Plans $113 2207%
Comm Care Network(Ccn)-All Plans $120 2344%
Great West-One Health Plan Ppo/Pos-All Plans $120 2344%
Phcs/Multiplan/Beech St-All Plans $120 2344%
Interplan-All Plans $124 2422%
Bps-All Plans $127 2480%
Ppo Alliance-All Plans $127 2480%
Pref Health Networl(Phn)-All Plans $127 2480%
Scan Mcare-All Plans $141 2754%
St Joseph Heritage Hltcare Mcr Adv $141 2754%
Correct Care Integ Health-All Plans $169 3301%
Employer Direct Healthcare-All Plans $169 3301%
Creative Legal Services-All Plans $183 3574%
Canopy Op Only $254 4961%
Vnpn - All Plans $254 4961%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals