CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: North Adams Regional Hospital Corporation

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $27
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 5.27x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at North Adams Regional Hospital Corporation is $27. 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 5.27x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $27 (527%)
Cash: $44 (859% of Medicare)
Ins. Median: $27 (527% 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 527% of the Medicare baseline (a markup of 427%). 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
Comm Hospice $5 - $11 98%
Mcd Masshealth $5 98%
Mcd New York $5 98%
Mcd Out Of State $5 98%
Mcdmanaged Bmchnp $5 98%
Mcdmanaged Cdphp $5 98%
Mcdmanaged Hne Mcdaco $5 98%
Mcdmanaged Network $5 - $26 98%
Mcr Miscellaneous $5 - $11 98%
Mcrmanaged Usa Family $5 - $11 98%
Mcrmanaged Va $5 - $11 98%
Medicaid / KanCare $5 - $20 98%
Medicare (plans) $5 - $11 98%
Oth United Vaccn $5 - $11 98%
Aetna $6 - $35 117%
Blue Cross Blue Shield $6 - $40 117%
Mcrmanaged Cca One Care $6 - $11 117%
Tricare $6 - $18 117%
Comm Fallon Qhp $8 - $26 156%
Comm Unicare $13 - $30 254%
Comm Network Qhpsub $26 - $28 508%
Wc Workers Comp $28 547%
Comm Network Qhpnonsub $30 - $34 586%
Comm Nhp $30 586%
Comm Hne $31 - $32 605%
Comm Hne Hmo $31 - $35 605%
Comm Hne Ppo $33 - $35 645%
Comm Tufts $37 723%
UnitedHealthcare $40 781%
Cigna $42 - $43 820%
Comm Cdphp $42 820%
Comm Mvp $42 820%
Comm Oxford $42 820%
Comm First Health $43 - $44 840%
Comm Connecticare $44 859%
Comm Consolidated Health $44 859%
Comm Harvard $44 859%
Comm Other $44 859%
Comm Phcs $44 859%
Comm Self Pay $44 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals