CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: St Louis Childrens Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $26
  • Cash Discount Price: $22
  • vs. Medicare Baseline: 5.08x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at St Louis Childrens Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.08x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.
Cash / Self-Pay
$22

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: $22 (430%)
Insurance Median: $26 (508%)
Cash: $22 (430% 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
Aetna $5 - $28 98%
Blue Cross Blue Shield $5 - $31 98%
Cox Health [757] $5 98%
Essence Healthcare [221] $5 98%
Humana $5 - $27 98%
Medica [662] $5 98%
UnitedHealthcare $5 - $27 98%
Healthlink [225] $17 - $27 332%
Cigna $18 - $20 352%
Apwu Health Plan [216] $20 391%
Consociate [478] $20 391%
Cox Health Systems Insurance Company [220] $20 - $27 391%
Nalc Health Benefit Plan [242] $20 391%
Priority Health [648] $20 391%
Sarah Bush Lincoln [636] $20 391%
Allied Benefits [498] $21 - $28 410%
Hope Trust [806] $21 410%
Med-Pay [480] $23 - $27 449%
Unicare [568] $23 - $27 449%
Health Alliance [224] $25 488%
Healthscope Benefits [258] $26 - $29 508%
Beechstreet [551] $27 527%
Detego Health [868] $27 527%
First Health Commercial [734] $27 527%
Health Systems Inc [620] $27 527%
Healthcare Sol Mercy [609] $27 527%
Multiplan Commercial [737] $27 527%
Multiplan [240] $27 527%
Phcs [244] $27 - $29 527%
Preferred Health Professionals [561] $27 527%
Coresource [497] $28 547%
Fmh Benefit Service Inc [222] $28 547%
Mail Handlers [495] $28 547%
Medica [661] $29 566%
Hfn [563] $31 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Childrens Place, Saint Louis, MO 63110
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens