CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Houlton Regional Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $26
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 5.08x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Houlton Regional Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.08x the Medicare baseline. Located in 20 Hartford Street, Houlton, ME.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $56 (1094%)
Insurance Median: $26 (508%)
Cash: $56 (1094% of Medicare)
Ins. Median: $26 (508% 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 508% of the Medicare baseline (a markup of 408%). 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
Blue Cross Blue Shield $12 - $26 234%
Tricare $25 488%
Aetna $26 508%
Wellcare $26 508%
Martins_Point $30 586%
Community_Health $52 1016%
Cigna $54 1055%
United $56 1094%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20 Hartford Street, Houlton, ME 04730
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals