CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $6
Cash Discount Price: $48
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at UMass Memorial Healthalliance Hospitals is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 1.17x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $48 (938%)

Insurance Median: $6 (117%)

Cash: $48 (938% of Medicare)

Ins. Median: $6 (117% 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.

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
Aetna	$5 - $31	98%
Blue Cross Blue Shield	$5 - $12	98%
Cigna	$5 - $20	98%
Commonwealth Care Mcr [10115]	$5	98%
Fallon Mcr Supp [20202]	$5	98%
Grants [20507]	$5 - $48	98%
Harvard Pilgrim Mcr [10106]	$5	98%
Institution [10406]	$5 - $25	98%
Medicaid / KanCare	$5 - $6	98%
Medicare (plans)	$5	98%
Mgb Mcr [10124]	$5	98%
Senior Whole Health [10110]	$5	98%
Tufts Dual [10111]	$5	98%
Tufts Mcr [10112]	$5	98%
Tufts Us Family [11203]	$5	98%
UnitedHealthcare	$5 - $48	98%
Champva [11001]	$6	117%
Masshealth [20302]	$6	117%
Correctional Care [11003]	$7 - $8	137%
Workers Compensation [20501]	$7	137%
Tufts Connectorcare [10507]	$9	176%
Tufts [11201]	$11	215%
Harvard Pilgrim [10701]	$13 - $16	254%
Wellpoint [11112]	$13	254%
Hne [11108]	$27	527%
First Health Network [11120]	$36	703%
Multiplan [11109]	$36	703%
Fallon Connectorcare [10503]	$45	879%
Connecticare [11105]	$48	938%
Fallon Carelon Hlth [28]	$48	938%
Fallon Mcaid Carelon Hlth [29]	$48	938%
Hsno/Free Care [10801]	$294	5742%

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 $48.
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 UMass Memorial Healthalliance Hospitals 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.