CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Elmhurst Hospital Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $25
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.88x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Elmhurst Hospital Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.88x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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%)
Insurance Median: $25 (488%)
Ins. Median: $25 (488% 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 488% of the Medicare baseline (a markup of 388%). 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
Aetna $4 - $15 78%
Healthfirst $4 - $55 78%
Elderplan $5 98%
Fidelis $5 - $55 98%
Magnacare $6 117%
Oxford $7 137%
United $7 - $31 137%
Oscar $8 156%
Centerlight $11 215%
Cigna $13 254%
Wellcare $13 254%
Carelon $14 - $25 273%
Emblem $15 - $33 293%
Blue Cross Blue Shield $17 - $55 332%
Multiplan $17 332%
Local 1199 $18 352%
Villagecare Max $18 352%
Vnsny $18 - $25 352%
Metroplus $24 - $55 469%
Affinity $25 - $55 488%
Amidacare $25 488%
Carelon (Amida Care) $25 488%
Senior Whole Health $25 488%
United Behavioral Health $25 - $27 488%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals