CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Loma Linda University Children's Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $23
Cash Discount Price: $38
vs. Medicare Baseline: 4.49x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Loma Linda University Children's Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.49x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$23

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: $38 (742%)

Insurance Median: $23 (449%)

Cash: $38 (742% of Medicare)

Ins. Median: $23 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
UnitedHealthcare	$4	78%
Alpha Care Medical Group	$5 - $8	98%
Dignity Health	$5 - $8	98%
Epic Health Plan	$5 - $39	98%
Inland Empire Health Plan (Iehp)	$5 - $7	98%
Kaiser Foundation Hospitals	$5 - $65	98%
Upland Medical Group	$5	98%
Vantage Medical Group	$5 - $8	98%
Molina Healthcare Of Ca	$6 - $7	117%
Adventist Health	$7 - $20	137%
Heritage Provider Network	$8	156%
Lluh Dept Of Risk Management	$8 - $24	156%
Blue Shield Of California	$15 - $57	293%
Global Benefits Group	$20 - $59	391%
Temecula Valley Physicians Medical Group	$20 - $51	391%
Trivalley Medical Group	$20 - $51	391%
Aetna	$22 - $56	430%
Cigna	$22 - $63	430%
Networks By Design	$22 - $64	430%
Multiplan	$27 - $78	527%
Galaxy Health	$29 - $83	566%
Prime Health Services	$29 - $83	566%
Blue Cross Blue Shield	$51	996%

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 $38.
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 Loma Linda University Children's Hospital 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.