CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: North Carolina Baptist Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $21
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 4.10x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at North Carolina Baptist Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.10x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $32 (625%)
Insurance Median: $21 (410%)
Cash: $32 (625% of Medicare)
Ins. Median: $21 (410% 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 410% of the Medicare baseline (a markup of 310%). 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 - $55 98%
Apex $5 98%
Blue Cross Blue Shield $5 - $24 98%
Cigna $5 - $39 98%
Devoted $5 98%
Healthteam $5 98%
Humana $5 - $36 98%
Medicare (plans) $5 98%
UnitedHealthcare $5 - $22 98%
Wellcare $5 - $9 98%
Liberty $6 117%
Amerihealth $9 - $15 176%
Carolina Complete $9 176%
Health Blue $9 176%
Partners $9 176%
Vaya $9 176%
Alliance $10 195%
Trillium $10 195%
Medcost $12 - $43 234%
Ambetter / Centene $14 - $15 273%
Oscar $18 - $23 352%
Directnet $36 - $38 703%
Cone Health $43 - $46 840%
Healthgram $43 - $46 840%
First Carolina Care $49 - $52 957%
Private Healthcare Systems $50 - $53 977%
Multiplan $55 - $58 1074%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals