CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Fairview Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $30
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 5.86x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Fairview Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.86x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $44 (859%)
Insurance Median: $30 (586%)
Cash: $44 (859% of Medicare)
Ins. Median: $30 (586% 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 586% of the Medicare baseline (a markup of 486%). 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
Aetna $5 - $35 98%
Bmchnp $5 98%
Capital District Physicians' Health Plan $5 - $42 98%
Fallon $5 - $20 98%
Health New England $5 - $32 98%
Hospice $5 - $18 98%
Medicaid / KanCare $5 98%
Medicare (plans) $5 - $18 98%
Other Government $5 - $18 98%
Point32Health $5 - $44 98%
UnitedHealthcare $5 - $40 98%
Blue Cross Blue Shield $6 - $40 117%
Commcare Alliance $6 - $18 117%
Comm Fallon Qhp $8 - $29 156%
Unicare $13 - $30 254%
Allways Nhp $30 586%
Workers Comp $30 586%
Comm Hne Hmo $31 - $35 605%
Comm Hne Ppo $33 - $35 645%
Cigna $42 - $43 820%
Mvp $42 820%
Oxford $42 820%
First Health $43 - $44 840%
Connecticare $44 859%
Consolidated Health Plans $44 859%
Other Commercial $44 859%
Phcs $44 859%
Self Pay $44 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals