CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Boston Children's Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $19
Cash Discount Price: $47
vs. Medicare Baseline: 3.71x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Boston Children's Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.71x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $47 (918%)

Insurance Median: $19 (371%)

Cash: $47 (918% of Medicare)

Ins. Median: $19 (371% 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 371% of the Medicare baseline (a markup of 271%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$3 - $58	59%
Cdphp	$3 - $75	59%
Harvard Pilgrim	$3 - $59	59%
Aetna	$4 - $74	78%
Ambetter / Centene	$4 - $56	78%
Carelon Strategies/Bhs	$4 - $57	78%
Carelon/Beacon	$4 - $66	78%
Mgb/Allways	$4 - $65	78%
Tufts Public Plan	$4 - $54	78%
United	$4 - $74	78%
United Ri Nj Ny	$4 - $55	78%
UnitedHealthcare	$4 - $75	78%
Cigna	$5 - $79	98%
Community Health Options	$5 - $79	98%
Ets/Lifetrac	$5 - $75	98%
Fallon	$5 - $68	98%
Health New England	$5 - $71	98%
Humana	$5 - $79	98%
Interlink Transplant	$5 - $75	98%
Coventry/Hcvm/First Health	$6 - $81	117%
Multiplan/Phcs	$6 - $84	117%
Unicare	$20	391%

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 $47.
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 Boston Children's Hospital 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.