CMS Price Transparency Data
Blood test, creatinine (kidney)
Facility: Trinity Health Oakland Hospital
Billing Code: 82565 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82565
- Insurance Median: $17
- Cash Discount Price: $167
- vs. Medicare Baseline: 3.32x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Trinity Health Oakland Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.32x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$167
Average discount available for prompt cash payment at this facility.
Insurance Median
$17
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: $167 (3262%)
Insurance Median: $17 (332%)
Cash: $167 (3262% of Medicare)
Ins. Median: $17 (332% 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 332% of the Medicare baseline (a markup of 232%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| U Of M Health Plan | $2 | 39% |
| Blue Cross Blue Shield | $3 - $5 | 59% |
| Medicaid / KanCare | $3 | 59% |
| Aetna | $5 - $17 | 98% |
| Align Senior Care | $5 | 98% |
| Blue Care Network Advantage | $5 | 98% |
| Cca - Zing Health | $5 | 98% |
| Hospice Advantage | $5 | 98% |
| Medicare (plans) | $5 | 98% |
| UnitedHealthcare | $5 - $28 | 98% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $6 | 117% |
| Molina Marketplace | $7 | 137% |
| Priority Health | $7 - $8 | 137% |
| Geha | $8 - $28 | 156% |
| Health Cost Solutions | $8 | 156% |
| Medical Mutual | $8 | 156% |
| Meritain | $8 | 156% |
| Vitalcore | $8 | 156% |
| Wellpath | $8 | 156% |
| Employee Benefit Logistic | $12 | 234% |
| Wc Accident Fund | $12 | 234% |
| Wc Advantage | $12 | 234% |
| Wc Aig | $12 | 234% |
| Wc Allied | $12 | 234% |
| Wc Amerisure | $12 | 234% |
| Wc Amtrust | $12 | 234% |
| Wc Asu Risk Mgt | $12 | 234% |
| Wc Berkley Admin | $12 | 234% |
| Wc Broadspire | $12 | 234% |
| Wc Bunch & Associates | $12 | 234% |
| Wc Ccmsi | $12 | 234% |
| Wc Emc Insurance Company | $12 | 234% |
| Wc Esis | $12 | 234% |
| Wc Fcci | $12 | 234% |
| Wc Federated | $12 | 234% |
| Wc Gallagher Bassett | $12 | 234% |
| Wc Genex Care For Ohio | $12 | 234% |
| Wc Guard Insurance Company | $12 | 234% |
| Wc Hartford | $12 | 234% |
| Wc Liberty Mutual | $12 | 234% |
| Wc Meijers | $12 | 234% |
| Wc Michigan | $12 | 234% |
| Wc Mitchell Frankenmuth | $12 | 234% |
| Wc Pma | $12 | 234% |
| Wc Sedgwick | $12 | 234% |
| Wc Sentry | $12 | 234% |
| Wc Travelers | $12 | 234% |
| Wc Tristar | $12 | 234% |
| Wc Walmart | $12 | 234% |
| Wc Zurich | $12 | 234% |
| Asr Health Benefits | $16 | 313% |
| Caresource | $16 | 313% |
| Hap | $16 - $28 | 313% |
| Varipro | $16 | 313% |
| Acs Benefit Services | $17 | 332% |
| Allied Benefit Systems | $17 | 332% |
| Claimchoice Adminstrators | $17 | 332% |
| Consociate | $17 | 332% |
| Cypress Benefit Administrators | $17 | 332% |
| Forest County Potawatomi | $17 | 332% |
| Health Smart | $17 | 332% |
| Healthgram | $17 | 332% |
| Healthscope | $17 | 332% |
| Secureone Preferred United Plans | $17 | 332% |
| Sisco Benefits | $17 | 332% |
| The Health Plan | $17 | 332% |
| Trustmark Small Business Benefits | $17 | 332% |
| Unified Group Services | $17 | 332% |
| Webtpa | $17 | 332% |
| Mclaren Health | $18 - $20 | 352% |
| Carelon Behavioral Health | $19 | 371% |
| Magellan Behavioral Health | $23 | 449% |
| 1199 National Benefit Fund | $26 | 508% |
| Allied National Global Care | $26 | 508% |
| Asrm - Reliance Standard Life Insurance | $26 | 508% |
| Christian Care Ministry | $26 | 508% |
| Dean Health | $26 | 508% |
| Fallon Health | $26 | 508% |
| Family Life Insurance Company | $26 | 508% |
| Ghc Scw | $26 | 508% |
| Group Pension Administrators | $26 | 508% |
| International Benefit Administrators | $26 | 508% |
| Lifetime Benefit Solutions | $26 | 508% |
| Manhattan Life | $26 | 508% |
| Medi Share | $26 | 508% |
| Multiplan | $26 | 508% |
| Mvp | $26 | 508% |
| Pai | $26 | 508% |
| Pan-American Life | $26 | 508% |
| Paramount Hmo | $26 | 508% |
| Phcs | $26 | 508% |
| Trinity Health Share | $26 | 508% |
| Access Health | $28 | 547% |
| Acclaim | $28 | 547% |
| Administrative Concepts | $28 | 547% |
| Allegeant | $28 | 547% |
| Ameriben | $28 | 547% |
| American Family | $28 | 547% |
| American Healthcare Alliance | $28 | 547% |
| American National | $28 | 547% |
| American Republic | $28 | 547% |
| Amerihealth | $28 | 547% |
| Aultcare | $28 | 547% |
| Automated Benefit Services | $28 | 547% |
| Auxiant | $28 | 547% |
| Benefit Administrative Systems,Llc | $28 | 547% |
| Boon Chapman | $28 | 547% |
| Cam Administrative Services | $28 | 547% |
| Christian Brother Services | $28 | 547% |
| Christian Brothers Holy Cross | $28 | 547% |
| Cigna | $28 | 547% |
| Comprehensive Benefits | $28 | 547% |
| Continental Life Insurance | $28 | 547% |
| Custom Benefit Administrators | $28 | 547% |
| Employee Benefit Concepts | $28 | 547% |
| Employee Benefit Management | $28 | 547% |
| Enterprise Group Planning | $28 | 547% |
| Freedom Life Insurance Company | $28 | 547% |
| Group Administrators | $28 | 547% |
| Group Marketing Services | $28 | 547% |
| Guardian | $28 | 547% |
| Health America | $28 | 547% |
| Health Choices | $28 | 547% |
| Health Partners | $28 | 547% |
| Healthcare Management Admin | $28 | 547% |
| Healthez | $28 | 547% |
| Humana | $28 | 547% |
| Insight | $28 | 547% |
| Intercare | $28 | 547% |
| Jfp Benefit Management | $28 | 547% |
| Jp Farley Corporation | $28 | 547% |
| Key Benefit Administrator | $28 | 547% |
| Liberty Union Life Assurance Co | $28 | 547% |
| Lucent Health | $28 | 547% |
| Luminare Health | $28 | 547% |
| Luminare Health (Detroit) | $28 | 547% |
| Magnacare | $28 | 547% |
| Medben | $28 | 547% |
| Medcost | $28 | 547% |
| Mutual Health Services | $28 | 547% |
| Mutual Of Omaha | $28 | 547% |
| Ncas | $28 | 547% |
| Nippon Life Ins | $28 | 547% |
| Nova | $28 | 547% |
| Painters Union Insurance Fund | $28 | 547% |
| Physicians Mutual | $28 | 547% |
| Plumbers Local 98 Insurance Fund | $28 | 547% |
| Prairie States | $28 | 547% |
| Preferred One | $28 | 547% |
| Primary Physician Care | $28 | 547% |
| Professional Benefit Administrators | $28 | 547% |
| Siho Insurance Services | $28 | 547% |
| The Loomis Company | $28 | 547% |
| Tufts Health Plan | $28 | 547% |
| Unicare | $28 | 547% |
| Us Health And Life | $28 | 547% |
| Valenz | $28 | 547% |
| Western & Southern Financial Group | $28 | 547% |
| Wps | $28 | 547% |
| Coventry | $29 | 566% |
| First Health | $29 | 566% |
| Prime Health Services | $30 | 586% |
| Three Rivers Provider Network | $34 | 664% |
| Cmh Detroit Wayne Integrated Health Network | $38 | 742% |
| Cmh Lenawee County | $38 | 742% |
| Cmh Livingston County | $38 | 742% |
| Cmh Misc | $38 | 742% |
| Cmh Monroe County | $38 | 742% |
| Cmh Oakland County | $38 | 742% |
| Cmh Washtenaw County | $38 | 742% |