CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Valley Children's Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $13
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.54x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Valley Children's Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.54x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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%)
Insurance Median: $13 (254%)
Ins. Median: $13 (254% 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 254% of the Medicare baseline (a markup of 154%). 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
Allcare Ipa $1 - $11 20%
Central Valley Medical Providers Ipa $1 - $62 20%
Dignity Health Central Coast $1 - $61 20%
United Physicians Network Ipa $1 - $11 20%
Aetna $2 - $82 39%
Bakersfield Family Medical Group $2 - $92 39%
Blue Cross Blue Shield $2 - $51 39%
Blue Shield $2 - $93 39%
Community Care Health Plan $2 - $98 39%
Community Health $2 - $68 39%
Dignity (Formerly Managed Care Systems) $2 - $77 39%
First Health Formerly Coventry $2 - $91 39%
Fowler Packing $2 - $76 39%
Health Net $2 - $81 39%
Health Plan Of San Joaquin $2 - $74 39%
Health Smart $2 - $98 39%
Kaiser $2 - $80 39%
Kern Legacy $2 - $80 39%
Key Medical Ipa $2 - $98 39%
Network By Design $2 - $95 39%
Physicians Choice Medical Group $2 - $69 39%
Stanislaus Partners In Health $2 - $68 39%
Sutter Health $2 - $105 39%
UnitedHealthcare $2 - $132 39%
Multiplan $3 - $118 59%
Central California Alliance For Health $10 195%
Dignity Ipa_Formerly Img $10 195%
La Salle Ipa $10 195%
Sante Ipa $10 195%
Community Care Ipa $11 215%
Sequoia Health Ipa $11 215%
Univseral Healthcare Ipa $11 215%
Adventist $13 254%
Cencal Health $14 273%
Kern Family Health Care $15 293%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens