CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Adventist Health Sonora

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $51
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 9.96x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Adventist Health Sonora is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 9.96x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $45 (879%)
Insurance Median: $51 (996%)
Cash: $45 (879% of Medicare)
Ins. Median: $51 (996% 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 996% of the Medicare baseline (a markup of 896%). 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
Kaiser - All Plans $2 - $217 39%
UnitedHealthcare $2 - $373 39%
Western Growers/Pinnacle - All Plans $2 - $230 39%
Blue Shield - All Other Plans $3 - $330 59%
Blue Shield Epn $3 - $329 59%
Trpn - Three Rivers Ppo - All Plans $3 - $347 59%
Affordable Health - All Plans $4 - $391 78%
Beech Street- All Plans $4 - $369 78%
Celtic Ca Hlth Well Mcal - All Plans $4 - $8 78%
Central Ca Alliance Ccs Mcal $4 - $7 78%
Central Ca Alliance Chdp Mcal $4 - $7 78%
Central Ca Alliance Mcal $4 - $7 78%
Cigna $4 - $412 78%
Greatwest Oa/Pos/Hmo $4 - $369 78%
Greatwest Ppo - All Other Plans $4 - $391 78%
Healthnet - All Other Plans $4 - $380 78%
Healthnet Mcal $4 - $9 78%
Interplan - All Plans $4 - $391 78%
Medi-Cal $4 - $6 78%
Multiplan - All Plans $4 - $391 78%
Phcs Ppo - All Plans $4 - $391 78%
Stanilaus Foundation - All Plans $4 - $412 78%
Aetna $5 - $52 98%
Blue Shield Mcare $5 98%
Healthnet Mcr Adv $5 98%
Phs Prime Health Srvcs-All Plans $5 98%
Tricare $5 98%
Ah Employee Health Plan - All Plans $9 176%
Bc Exchange $47 918%
Bc Non-Mcs - All Other Plans $52 1016%
Bc Mcs $62 1211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals