CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Children's Specialized Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $31
  • Cash Discount Price: $21
  • vs. Medicare Baseline: 6.05x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Children's Specialized Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 6.05x the Medicare baseline. Located in 200 Somerset St, New Brunswick, NJ.
Cash / Self-Pay
$21

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $21 (410%)
Insurance Median: $31 (605%)
Cash: $21 (410% of Medicare)
Ins. Median: $31 (605% 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 605% of the Medicare baseline (a markup of 505%). 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
Blue Cross Blue Shield $4 - $40 78%
Fidelis Care $4 78%
UnitedHealthcare $4 78%
Cigna $25 488%
First Health $25 488%
Emblem Health $28 547%
Aetna $31 - $32 605%
Amerihealth $31 605%
Wellpoint $31 605%
Qualcare Inc $32 625%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Somerset St, New Brunswick, NJ 08901
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens