CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $63
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 12.30x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Cincinnati Children's Hospital Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 12.30x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $35 (684%)
Insurance Median: $63 (1230%)
Cash: $35 (684% of Medicare)
Ins. Median: $63 (1230% 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 1230% of the Medicare baseline (a markup of 1130%). 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 - $65 98%
Humana $5 - $18 98%
Passport_Ky $5 98%
United_Health_Care_Ky $5 98%
Wellcare_Ky $5 98%
Blue Cross Blue Shield $7 - $67 137%
Caresource_In $7 137%
Mhs_In $7 137%
Caresource_Oh $18 352%
United_Health_Care_Oh $18 352%
Amerihealth_Caritas_Oh $19 371%
Molina_Oh $19 371%
Buckeye_Oh $20 391%
Caresource_Oh_Insurance $33 645%
Cigna $33 - $65 645%
Medical_Mutual_Of_Ohio_Insurance $42 - $65 820%
Point_Comfort_Insurance $44 859%
Margaret_Mary_Health_Insurance $53 1035%
Parkview_Signature_Care_Insurance $53 1035%
United_Health_Care_Insurance $61 1191%
Health_Ohio_Network_Insurance $62 - $65 1211%
Custom_Design_Benefits_Insurance $65 1270%
Health_Smart_Preferred_Insurance $65 1270%
Medical_Benefit_Administrators_Insurance $65 1270%
Ohio_Health_Choice_Insurance $65 1270%
Private_Health_Care_Systems_Insurance $65 1270%
Beechstreet_Insurance $67 1309%
First_Health_Group_Insurance $67 1309%
Health_Link_Insurance $67 1309%
Evolutions_Health_Care_Systems $68 1328%
Galaxy_Health_Insurance $68 1328%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens