CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: UPMC Hamot

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $22
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 4.30x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at UPMC Hamot is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.30x the Medicare baseline. Located in 201 State Street, Erie, PA.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $65 (1270%)
Insurance Median: $22 (430%)
Cash: $65 (1270% of Medicare)
Ins. Median: $22 (430% 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 430% of the Medicare baseline (a markup of 330%). 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 - $76 98%
Blue Cross Blue Shield $5 - $48 98%
Fidelis $5 98%
Independent Health $5 98%
UnitedHealthcare $5 - $7 98%
Upmc Health Plan $5 - $10 98%
Upmc Work Partners $5 98%
Wellcare $5 98%
Amerihealth Caritas $6 - $10 117%
Cigna $6 - $44 117%
Health Partners Plans (Jefferson Health Plan) $6 117%
Highmark Wholecare (Prev Gateway) $6 - $54 117%
Pa Health & Wellness $6 - $11 117%
Geisinger $9 176%
Univera $16 - $48 313%
Intergroup $71 - $87 1387%
Multiplan $76 - $87 1484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 State Street, Erie, PA 16550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals