CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Southcoast Hospitals Group

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $6
Cash Discount Price: $25
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Southcoast Hospitals Group is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 1.17x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$25

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: $25 (488%)

Insurance Median: $6 (117%)

Cash: $25 (488% 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 - $37	98%
Blue Cross Blue Shield	$5 - $10	98%
Commonwealth Care Alliance [1080501]	$5	98%
Evercare [1010304]	$5	98%
Medicare (plans)	$5 - $12	98%
Tufts Health Public Plans [1010213]	$5	98%
Tufts Senior Care Options [1010315]	$5	98%
UnitedHealthcare	$5 - $6	98%
Wellsense Health Plan Senior Care Options [1020208	$5	98%
Eternal Health [1010322]	$6	117%
Fallon [1000114]	$7	137%
Wellsense Health Plan Clarity Connectorcare & Meta	$10	195%
Cigna	$12	234%
Harvard Pilgrim [1010602]	$12	234%
Wellpoint [1000102]	$16	313%
Tufts [1010701]	$20	391%
Mass General Brigham Health Plan Commercial [10122	$28	547%
Mass General Brigham Health Plan Connectorcare [10	$28	547%
Group Insurance Service Center [1013001]	$29	566%
Innovative Health Plan [1025001]	$29	566%
Priority Health [1015001]	$29	566%
PHCS [1000125]	$32	625%
First Health [1000130]	$37	723%

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 $25.
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 Southcoast Hospitals Group 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.