CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Essentia Health

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $42
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 8.20x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Essentia Health is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.20x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $71 (1387%)
Insurance Median: $42 (820%)
Cash: $71 (1387% of Medicare)
Ins. Median: $42 (820% 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 820% of the Medicare baseline (a markup of 720%). 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
Advocare/Security Health $5 98%
Blue Cross Blue Shield $5 - $63 98%
Freedom Blue Ppo $5 98%
Healthpartners Care Msho / Mcr Adv $5 98%
Imcare Msho Pcc Prime $5 98%
Imcare Msho Ref Req $5 98%
Itasca Med Care $5 98%
Medica Advantage Solutions $5 98%
Medica Msho/Dual Solutions $5 98%
Medica Prime Solution Group $5 98%
Medicare (plans) $5 98%
Nd Va Administration $5 98%
Platinum Blue/Vantage Blue $5 98%
Primewest $5 98%
Primewest Msho $5 98%
Secure Blue Msho $5 98%
Ubh Cost Plan $5 98%
Ubh Msho $5 98%
Ucare Msho $5 98%
UnitedHealthcare $5 - $75 98%
Sanford Health Plan $16 - $42 313%
Medica Access $25 488%
Healthpartners Care Pmap $37 723%
Medica $52 - $58 1016%
Medica Uplan $52 1016%
Medica Choice $60 1172%
Ucare $62 1211%
Cigna $63 1230%
Healthpartners $63 1230%
Healthpartners Pcc Prime $63 1230%
Wea $68 - $72 1328%
America'S Ppo $73 1426%
Wps $78 - $79 1523%
Aetna $80 1563%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals