CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Pender Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $44
Cash Discount Price: $33
vs. Medicare Baseline: 8.59x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Pender Memorial Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.59x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $33 (645%)

Insurance Median: $44 (859%)

Cash: $33 (645% of Medicare)

Ins. Median: $44 (859% 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 859% of the Medicare baseline (a markup of 759%). 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
Humana	$17 - $67	332%
Blue Cross Blue Shield	$18 - $56	352%
New Hanover Health	$18 - $21	352%
Pace Of The Southern Piedmont	$18 - $21	352%
Aetna	$19 - $66	371%
Amerihealth	$19 - $22	371%
Carolina Complete	$19 - $22	371%
Cigna	$19 - $34	371%
Nc Department Of Public Safety	$19 - $42	371%
Wellcare	$19 - $22	371%
Ambetter / Centene	$25 - $29	488%
Liberty Health	$26 - $30	508%
Caresource North Carolina	$27 - $31	527%
Plotkin Health	$40 - $47	781%
UnitedHealthcare	$49 - $57	957%
Medcost	$50 - $65	977%
Employers Choice Network	$65 - $76	1270%
Three Rivers Provider Network	$65 - $76	1270%

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 $33.
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 Pender Memorial 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.