CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $6
  • Cash Discount Price: $81
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Montefiore Mount Vernon Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 1.17x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$81

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $81 (1582%)
Insurance Median: $6 (117%)
Cash: $81 (1582% of Medicare)
Ins. Median: $6 (117% 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.

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
Wellcare $4 - $5 78%
Amidacare $5 - $6 98%
Blue Cross Blue Shield $5 - $99 98%
Centerlight $5 - $6 98%
Emblem $5 - $99 98%
Fidelis $5 - $9 98%
Healthfirst $5 - $8 98%
Medicaid / KanCare $5 98%
Point Comfort $5 98%
UnitedHealthcare $5 - $10 98%
Villagecaremax $5 98%
Vnsny Choice $5 - $6 98%
Humana $6 117%
Longevity $6 117%
Vnsny Select Health $6 117%
Metroplus $7 137%
Oscar $7 137%
American Postal Workers $10 195%
Mvp $10 195%
Aetna $23 - $26 449%
Cigna $50 - $55 977%
Centivo $78 1523%
Elderplan $99 1934%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals