CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $18
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 3.52x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Mt Sinai Hospital Medical Center is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.52x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $24 (469%)
Insurance Median: $18 (352%)
Cash: $24 (469% of Medicare)
Ins. Median: $18 (352% 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 352% of the Medicare baseline (a markup of 252%). 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
Oscar - All Plans $2 - $42 39%
Advocate Physician Prtnrs Mcr $5 98%
Blue Cross Blue Shield $5 - $24 98%
Cenpatico Illinicare Dual $5 98%
Cenpatico Illinicare Mcr - All Other Plans $5 98%
Cigna $5 - $48 98%
Harmony Behavioral Htlh - All Plans $5 98%
Humana $5 - $121 98%
Lawndale Christian - All Plans $5 - $7 98%
Meridian/Harmony D-Snp - All Plans $5 98%
Molina Mcr - All Other Plans $5 98%
Nextlevel Hlth Icp Fhp Aca - All Plans $5 98%
Tricare $5 98%
UnitedHealthcare $5 98%
Va Healthnet - All Plans $5 98%
Zing Mcr Adv - All Plans $5 98%
Advocate Physician Prtnrs - All Other Plans $6 117%
Ambetter / Centene $6 - $40 117%
Aetna $7 - $87 137%
Family Health Network Mcaid - All Plans $7 137%
Molina Mcaid $8 156%
Partners In Hlth - All Plans $12 - $15 234%
Healthlink Hmo $15 - $19 293%
Healthlink Ppo - All Other Plans $15 - $19 293%
Compsych Ip/Op Only - All Plans $18 - $23 352%
Hfn Platinum $20 - $25 391%
Multiplan Primary Ntwrk/Phcs - All Other Plans $21 - $27 410%
Hfn Epo $24 - $31 469%
Multiplan Complementary Ntwrk $24 - $31 469%
Hfn Ppo - All Other Plans $26 - $34 508%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals