CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Lancaster General Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $23
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Lancaster General Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.49x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $40 (781%)
Insurance Median: $23 (449%)
Cash: $40 (781% of Medicare)
Ins. Median: $23 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
Blue Cross Blue Shield $2 - $34 39%
Tricare $4 78%
Aetna $5 - $22 98%
Albright Life $5 98%
Amerihealth Caritas $5 - $6 98%
Cigna $5 - $33 98%
Coatesville Va $5 98%
Devoted Health $5 98%
Health Partners Mcr Advantage $5 98%
Highmark $5 - $40 98%
Hospice Generic $5 98%
Lebanon Veterans Hospital $5 98%
Medicare (plans) $5 - $6 98%
Pa Health And Wellness Mcr $5 98%
UnitedHealthcare $5 - $34 98%
Lancaster County Mh $6 117%
Medicaid / KanCare $6 - $11 117%
Elap Employees $7 137%
Hospice And Community Care $7 - $8 137%
Gateway $8 156%
Oscar Health Plan $10 195%
Lg Coresource/Lg Eliance $11 215%
Old Order Group $11 - $13 215%
Upmc For You $11 215%
Highmark Commercial Preferred $12 - $40 234%
Lancashire Hall $12 - $40 234%
Nursing Home Op Services $12 234%
Claim Watcher Plus $15 293%
Affilia Home Health $16 - $40 313%
Masonic Homes $16 - $40 313%
Claim Watcher $17 332%
Eliance Health Solutions $18 - $26 352%
Elap Other Groups $19 371%
Highmark Commercial Non-Preferred $19 - $40 371%
Preferred Healthcare $23 - $34 449%
Ehp $32 - $33 625%
Upmc Commercial $32 - $34 625%
Devon $33 - $34 645%
Geisinger Commercial $33 - $34 645%
Intergroup Services $33 - $34 645%
Medi-Share Christian Care $37 - $38 723%
Commercial Generic $39 - $40 762%
Magellan $39 - $40 762%
United Behavioral Health $39 - $40 762%
Value Options $39 - $40 762%
Workers Compensation $39 - $40 762%
Gift Of Life Donor Program $13,500 263672%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals