CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Nemours Children's Hospital, Delaware

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $76
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 14.84x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Nemours Children's Hospital, Delaware is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 14.84x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $159 (3105%)
Insurance Median: $76 (1484%)
Cash: $159 (3105% of Medicare)
Ins. Median: $76 (1484% 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 1484% of the Medicare baseline (a markup of 1384%). 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
Keystone First Hlth Plan $1 - $95 20%
Aetna $2 - $125 39%
Amerihealth Caritas Delaware $2 - $123 39%
Blue Cross Blue Shield $2 - $190 39%
Celtic Transplant For De First Health $2 - $75 39%
Fidelis $2 - $86 39%
Health Partners $2 - $83 39%
Kidz Partners $2 - $81 39%
Priority Partners John Hopkins $2 - $105 39%
Six Degrees Health Transplant $2 - $108 39%
UnitedHealthcare $2 - $134 39%
Upmc $2 - $85 39%
Wellpoint Maryland $2 - $80 39%
Ambetter / Centene $3 - $123 59%
Cigna $3 - $135 59%
Geisinger Health Plan $3 - $129 59%
Great West-One Health Plan $3 - $135 59%
Integra Administrative Group $3 - $129 59%
National Transplant Network (Ntn) $3 - $140 59%
Six Degrees Health $3 - $140 59%
Star Healthcare Network $3 - $140 59%
Life Trac Solid Organ And Bmt Transplant $4 - $150 78%
Carefirst Md Community Health Plan $5 98%
Celtic Transplant $5 - $215 98%
First Health Network $5 - $204 98%
Insurance Administrators Of America $5 - $204 98%
Interlink Transplant Network $5 - $204 98%
Multiplan $5 - $204 98%
Preferred Healthcare $5 - $204 98%
Private Healthcare Systems $5 - $204 98%
Three Rivers Provider Network $5 - $204 98%
Tricare $5 98%
Us Family Health Plan $6 117%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens