CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $42
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 8.20x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Hospital of Univ of Pennsylvania is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.20x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $120 (2344%)
Insurance Median: $42 (820%)
Cash: $120 (2344% of Medicare)
Ins. Median: $42 (820% 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 820% of the Medicare baseline (a markup of 720%). 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 - $31 39%
Ibc Commercial Hpn $2 39%
Keystone Hmo Proactive $2 39%
Cigna $3 - $76 59%
Gspp And Wissahickon Hospice $3 59%
Aetna $5 - $170 98%
Devoted Health $5 98%
Geisinger Health Plan $5 - $16 98%
Health Partners $5 - $170 98%
Humana $5 - $136 98%
Ibc $5 98%
Kaiser Permanente $5 - $170 98%
Medicare (plans) $5 98%
Pa Health And Wellness $5 - $8 98%
Penn Life (Living Independently For Elders) $5 98%
Philadelphia Va Medical Center $5 98%
UnitedHealthcare $5 - $170 98%
Upmc $5 - $170 98%
Clover Health Plan $6 117%
Gateway Health Plan $6 117%
Keystone First $6 117%
Medicaid / KanCare $6 - $170 117%
Pa Medical Assistance $6 - $170 117%
Paired Kidney Exchange $6 - $14 117%
Tricare $6 117%
Us Family Health Plan $6 117%
Elap $7 137%
Claims Watcher $8 - $9 156%
Keystone Mercy Health Plan $8 - $170 156%
Centivo $9 176%
Oscar Health Plan $9 176%
Elap Services $10 195%
Highmark $11 215%
Horizon Nj Health $12 - $30 234%
Penn Global Medicine $14 273%
Preferred Health Care Eliance $15 - $37 293%
Pgm - Regie De L'Assurance Maladie Quebec $16 - $39 313%
Pgm - Kuwait Defense $24 - $76 469%
Qualcare $27 - $65 527%
Coventry $28 - $87 547%
Olympus $28 - $67 547%
Pgm - Chop $28 - $68 547%
Wissahickon Hospice $28 - $68 547%
Healthamerica/Coventry $32 - $83 625%
First Health Global $35 - $85 684%
Health Net $42 - $102 820%
Pgm - Royal Embassy Of Saudi Arabia $42 - $102 820%
Pgm - Embassy Of Qatar $46 - $110 898%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $46 - $110 898%
Interlink $47 - $114 918%
Pgm - Embassy Of The United Emirates/Ipc $49 - $119 957%
Health America/Ccn $56 - $136 1094%
Intergroup $56 - $136 1094%
Pgm - Kuwait Health Division $56 - $136 1094%
Pgm - Kuwait Oil $56 - $136 1094%
Preferred Care $56 - $136 1094%
Blue Quality Centers For Transplant (Bqct) $70 - $170 1367%
City Of Philadelphia Behavioral Health $70 - $170 1367%
Commercial Other $70 - $170 1367%
International Pfs $70 - $170 1367%
United Behavioral Health $70 - $170 1367%
Workers Compensation $70 - $170 1367%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals