CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: City of Hope National Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $14
Cash Discount Price: $28
vs. Medicare Baseline: 2.73x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at City of Hope National Medical Center is $14. 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 2.73x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $14 (273%)

Cash: $28 (547% of Medicare)

Ins. Median: $14 (273% 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 273% of the Medicare baseline (a markup of 173%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Net	$3 - $45	59%
Blue Cross Blue Shield	$5 - $51	98%
Cal Optima	$5 - $6	98%
Heritage Provider Network	$5 - $32	98%
Blue Shield	$6 - $59	117%
Inland Empire	$6 - $37	117%
UnitedHealthcare	$6 - $26	117%
Blue Shield Covca	$7 - $28	137%
Facey	$7	137%
Blue Shield Promise	$8 - $32	156%
Cencal	$9 - $37	176%
La Care Health	$9 - $37	176%
Prime Healthcare Keenan	$9 - $44	176%
Kaiser	$10 - $41	195%
Aetna	$11 - $46	215%
Gold Coast	$11 - $46	215%
Molina	$11 - $60	215%
Cigna	$12 - $49	234%
St. Joseph Heritage	$13 - $55	254%
Primecare Medical Network	$14 - $60	273%
First Health	$17 - $71	332%
Healthcare Partners	$18	352%
Phcs Multiplan	$20 - $83	391%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $28.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm City of Hope National Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.