CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Northside Hospital Duluth

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $43
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 8.40x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Northside Hospital Duluth is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.40x the Medicare baseline. Located in 3620 Howell Ferry Road, Duluth, GA.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $59 (1152%)
Insurance Median: $43 (840%)
Cash: $59 (1152% of Medicare)
Ins. Median: $43 (840% 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 840% of the Medicare baseline (a markup of 740%). 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
Institutional Gwinnett Os100 Discount $3 59%
Institutional Gwinnett Os100 Standard $3 59%
Fairly Group $4 78%
Aetna $5 - $16 98%
Bccp $5 98%
Blue Cross Blue Shield $5 - $55 98%
Caresource $5 - $29 98%
Cbww $5 98%
Champus Va $5 98%
Clear Springs Eon Health $5 98%
Clover Health $5 98%
Coventry $5 - $54 98%
Humana $5 98%
Institutional Gwinnett County Govt $5 98%
Kaiser $5 - $69 98%
Medicaid / KanCare $5 - $6 98%
Medicare (plans) $5 - $6 98%
Pruitt Health Premier $5 98%
Tricare $5 98%
UnitedHealthcare $5 - $13 98%
Va Ccn $5 98%
Wellcare $5 98%
Ambetter / Centene $6 - $17 117%
Amerigroup $7 - $14 137%
Corvel Workers Comp $8 156%
Employers Choice Network $8 156%
Georgia Workers Compensation $8 156%
Oscar $8 156%
Streamline Imaging $8 156%
Us Dept Of Labor Wc $9 176%
Cigna $12 - $50 234%
Northside Health Network $24 469%
Georgia Reproductive Specialists $32 625%
Medlien Healthcare Services $32 625%
Med Care Solutions $36 703%
Health One Alliance_Ppo $43 840%
Quick Trip $43 840%
Novanet_Ppo $55 1074%
Phcs $59 1152%
Beech Steet $67 1309%
Multiplan $67 1309%
Multiplan Workers Comp $67 1309%
Careiq $79 1543%
Dekalb_Department Of Health $79 1543%
Fifa $79 1543%
Institutional Marietta Surgery Center $79 1543%
Institutional Veterans Evaluation Services $79 1543%
Johnson Ferry Imaging $79 1543%
Marietta Dermatology Clinical Research Inc $79 1543%
Rabun County Boc $79 1543%
West Paces Imaging Agreement $79 1543%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3620 Howell Ferry Road, Duluth, GA 30096
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals