CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Samaritan Hospital of Troy, New York

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $13
  • Cash Discount Price: $158
  • vs. Medicare Baseline: 2.54x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Samaritan Hospital of Troy, New York is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 2.54x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$158

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $158 (3086%)
Insurance Median: $13 (254%)
Cash: $158 (3086% of Medicare)
Ins. Median: $13 (254% 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 254% of the Medicare baseline (a markup of 154%). 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 $5 - $17 98%
Albany County Correctional Facility $5 98%
Blue Cross Blue Shield $5 - $23 98%
Eddy Seniorcare Pace $5 98%
Medicaid / KanCare $5 - $79 98%
Medicare (plans) $5 - $79 98%
Mvp $5 98%
Nascentia Health Options $5 98%
Secure Horizons Ma Pffs $5 98%
UnitedHealthcare $5 - $79 98%
Hudson Headwaters Pace $6 117%
Nascentia Health Plus $6 117%
Fidelis Care $9 176%
Wellpath $12 234%
Bcn Domestic $13 254%
Blue Care Network $13 254%
Harvard Pilgrim Healthcare $13 254%
Unicare $13 254%
Blue Shield - Ny Highmark Northeastern $14 - $23 273%
1199 National Benefit Fund $17 332%
Allied Benefit Systems $17 332%
Asr Health Benefits $17 332%
Christian Brother Services $17 332%
Geha $17 332%
Lucent Health $17 332%
Luminare Health $17 332%
Medical Mutual $17 332%
Meritain $17 332%
Trustmark Small Business Benefits $17 332%
Blue Shield - Ca $23 449%
Blue Shield - Id (Regence) $23 449%
Blue Shield - Ny Highmark Western $23 449%
Blue Shield - Pa (Highmark) $23 449%
Blue Shield - Wa (Regence) $23 449%
Allegiance $36 703%
American Postal Workers Secondary $36 703%
Cigna $36 703%
Diversified Administrators $36 703%
Health Partners $36 703%
Priority Health $36 703%
Tufts Health Plan $36 703%
Webtpa $36 703%
Emblem Health $40 781%
Nova $40 781%
First Health $63 1230%
Health Republic $67 1309%
Independent Health $67 1309%
Magnacare $67 1309%
Health New England $71 1387%
Multiplan $71 1387%
Phcs $71 1387%
Carelon Behavioral Health $79 1543%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals