CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Cambridge Health Alliance

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $23
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Cambridge Health Alliance is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.49x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $23 (449%)
Insurance Median: $23 (449%)
Cash: $23 (449% of Medicare)
Ins. Median: $23 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
Boston Medical Center - Wellsense [50003] $5 98%
Fallon [50006] $5 98%
Mass Bh Partnership [70098] $5 98%
Mass General Brigham [50021] $5 - $15 98%
Mass Health [70001] $5 98%
Medicaid / KanCare $5 98%
Medicare (plans) $5 - $23 98%
Other Tufts Health Public Plan [75002] $5 - $8 98%
Tufts Together W Cha [75001] $5 98%
UnitedHealthcare $5 - $18 98%
Aarp [40001] $7 137%
Oxford Health [40004] $7 137%
United Medical Resource [40005] $7 137%
Wc [90001] $7 137%
Blue Cross Blue Shield $10 - $23 195%
Wellpoint [50012] $10 195%
Aetna $14 - $23 273%
Cigna $15 - $35 293%
Tufts Health Plan [30001] $15 - $17 293%
Multiplan [50010] $16 313%
Health Plans Inc [20002] $18 352%
Hphc [20001] $18 352%
Altus Dental [99011] $23 449%
Beacon Health Strategies [50002] $23 449%
Cbhc Uninsured Crisis Alt Payer [70097] $23 449%
Cbhc Uninsured Crisis [70096] $23 449%
Celticare [50004] $23 449%
Commonwealth Care Alliance Dental [99004] $23 449%
Coverage Discovery [90004] $23 449%
Delta Dental Of Ma [99007] $23 449%
Dominion National Dental [99012] $23 449%
Dph Tb Payor [85004] $23 449%
Esp Dental [99003] $23 449%
Eyemed Alt Payor [13001] $23 449%
First Health [50007] $23 449%
Global Medical Management [50024] $23 449%
Government Employee Health Association [50023] $23 449%
Guardian Dental [99013] $23 449%
Health Safety Net Dental [99002] $23 449%
Humana $23 449%
Ma Laborers Health And Welfare Fund [50022] $23 449%
Magellan Health Services [65098] $23 449%
Mass Health Dental [99001] $23 449%
Medical Mutual Of Ohio [50019] $23 449%
Metlife Dental [99008] $23 449%
Modern Assistance Program [30098] $23 449%
Mva [90002] $23 449%
Neighborhood Health Plan [50011] $23 449%
Other Bh Payor [50014] $23 449%
Other Commercial Payor [50015] $23 449%
Other Dental Payor [99014] $23 449%
Other Dual Eligible Payer [65004] $23 449%
Other Gov'T Alt [85006] $23 449%
Other Vision Payor [50013] $23 449%
Ri Neighborhood Health Plan [50017] $23 449%
Tricare $23 449%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals