CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $15
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 2.93x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Transylvania Regional Hospital, Inc is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.93x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $47 (918%)
Insurance Median: $15 (293%)
Cash: $47 (918% of Medicare)
Ins. Median: $15 (293% 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 293% of the Medicare baseline (a markup of 193%). 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
Apex Health $4 - $15 78%
Blue Cross Blue Shield $4 - $15 78%
Partners Health Management $4 - $15 78%
United $4 - $33 78%
Vaya Health $4 - $15 78%
Wellcare $4 - $14 78%
Amerihealth $7 137%
Amerihealth Caritas $8 - $30 156%
Cigna $8 - $38 156%
Caresource $9 - $33 176%
Magellan $12 - $45 234%
Magellan Behavioral Health $12 - $45 234%
Medcost $12 - $63 234%
Aetna $15 - $54 293%
Multiplan $16 - $60 313%
Avalon Administrative Services $18 - $63 352%
Prime Health $18 - $67 352%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals