CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Greater El Monte Community Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $22
  • Cash Discount Price: $105
  • vs. Medicare Baseline: 4.30x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Greater El Monte Community Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.30x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$105

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $105 (2051%)
Insurance Median: $22 (430%)
Cash: $105 (2051% of Medicare)
Ins. Median: $22 (430% 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 430% of the Medicare baseline (a markup of 330%). 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
Clinica Medica Familiar $1 - $61 20%
Alta Med Health Services Med Grp $2 - $30 39%
Bella Vista Medical Group Ipa $2 - $55 39%
Employee Health Systems Medical Group $2 - $24 39%
Global Care Medical Group Ipa $2 - $55 39%
Ahmc Reciprocity Agreement $3 - $37 59%
Ahmc Reciprocity Agreement Senior/Commercial $3 - $37 59%
Allied Physicians Medical Group $3 - $37 59%
Blue Cross Blue Shield $3 - $61 59%
Good Samaritan Medical Practice Assoc $3 - $73 59%
Lincoln Hospital Medical Center $3 - $37 59%
Molina Healthcare Of California $3 - $48 59%
Ahmc Healthcare Inc $4 78%
Aids Health Foundation $4 - $5 78%
Altamed Health Network $4 - $5 78%
Avanti $4 - $6 78%
Beverly Hospital $4 - $6 78%
Blue Shield Of California $4 - $71 78%
Brand New Day $4 - $6 78%
California Thoroughbred Horesmans Foundation $4 - $61 78%
Emanate Health $4 - $6 78%
Health Net Foundation $4 - $79 78%
Healthy Way La $4 78%
La Care Health Plan $4 - $67 78%
Other Non Contracted Medi-Cal Hmo $4 78%
State Of California $4 78%
Universal Care $4 - $85 78%
Veterans Administration $4 78%
Alignment Health Plan $5 98%
Allied Physicians $5 - $8 98%
Apa/Aco Inc $5 98%
Associated Hispanic Physicians $5 98%
Care 1St Health Plan $5 - $73 98%
Cms $5 98%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $5 98%
Easy Choice Health Plan $5 98%
Health Net Inc $5 - $86 98%
Hollywood Presbyterian Adv Med Mcal $5 98%
Hollywood Presbyterian Medpoint Mcal $5 98%
Inter Valley Health Plan $5 98%
La Care Covered Direct $5 98%
Molina Healthcare $5 98%
Other Non Contracted Senior Hmo $5 98%
Pacific Alliance Medical Center Reciprocal Contract $5 98%
Pacificare Of California $5 - $106 98%
Scan Health Plan $5 98%
Self-Pay $5 98%
UnitedHealthcare $5 - $105 98%
Ahmc Health Self-Insurance Epo $6 117%
Athens Administrators $6 117%
Caloptima $6 117%
Central Health Plan $6 - $85 117%
Champus Foundation $6 117%
Chinatown Service Center Pace $6 117%
Cigna $6 117%
Cost Containment Strategies $6 - $79 117%
In Custody Police Dept $6 - $79 117%
Intercomp $6 117%
Interplan $6 - $92 117%
Knox-Keene Act $6 117%
Multiplan $6 - $104 117%
Other Non Contracted Work Comp $6 117%
Preferred Health Network $6 117%
San Miguel Health Plan $6 117%
Community Care Network $7 - $98 137%
Health Payors Organization $8 - $110 156%
Care 1St Medi Cal Hmo Cap Exceptional Care $9 - $12 176%
Care First Health Plan $9 - $12 176%
Commercial Non Contract $9 - $122 176%
Medi-Cal Sub Acute $9 - $122 176%
Nuclear Medicine/Whmc $9 - $122 176%
One Legacy $9 - $122 176%
In Custody-Ca Highway Patrol $20 391%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals