CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Penn State Health St. Joseph

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $6
Cash Discount Price: $9
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Penn State Health St. Joseph is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 1.17x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $9 (176%)

Insurance Median: $6 (117%)

Cash: $9 (176% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
[Amerihealth Caritas]	$4 - $5	78%
[Highmark Wholecare]	$4 - $5	78%
Aetna	$5 - $14	98%
Humana	$5	98%
UnitedHealthcare	$5 - $22	98%
[Cbc]	$5 - $17	98%
[Geisinger]	$5 - $24	98%
[Health Partners Plans]	$5	98%
[Healthspring]	$5	98%
[Highmark]	$5 - $19	98%
[Ibc]	$5 - $16	98%
[Pa Health & Wellness]	$5	98%
[Upmc]	$5 - $24	98%
[Point Comfort Underwriters]	$6	117%
Cigna	$15	293%
[Highmark Choice Blue]	$15	293%
[Highmark Aca]	$16	313%
[Preferred Healthcare Systems]	$25	488%
[First Health]	$26	508%
[Multiplan]	$26	508%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $9.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Penn State Health St. Joseph is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.