CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Penn Presbyterian Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $59
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 11.52x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Penn Presbyterian Medical Center is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 11.52x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

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: $185 (3613%)
Insurance Median: $59 (1152%)
Cash: $185 (3613% of Medicare)
Ins. Median: $59 (1152% 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 1152% of the Medicare baseline (a markup of 1052%). 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 - $185 39%
Ibc Commercial Hpn $2 39%
Keystone Hmo Proactive $2 39%
Cigna $3 - $59 59%
Aetna $5 - $185 98%
Geisinger Health Plan $5 - $16 98%
Health Partners $5 - $185 98%
Humana $5 - $148 98%
Ibc $5 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 - $185 98%
Upmc $5 - $185 98%
Clover Health Plan $6 117%
Gateway Health Plan $6 117%
Keystone First $6 117%
Medicaid / KanCare $6 - $185 117%
Pa Medical Assistance $6 117%
Tricare $6 117%
Us Family Health Plan $6 117%
Elap $7 137%
Claims Watcher $8 - $9 156%
Keystone Mercy Health Plan $8 - $185 156%
Centivo $9 176%
Oscar Health Plan $9 176%
Elap Services $10 195%
Highmark $11 215%
Penn Global Medicine $14 273%
Horizon Nj Health $31 - $33 605%
Pgm - Regie De L'Assurance Maladie Quebec $43 840%
Preferred Health Care Eliance $46 898%
Pgm - Kuwait Defense $65 - $83 1270%
Devon $70 - $83 1367%
Qualcare $70 1367%
Coventry $74 - $94 1445%
Pgm - Chop $74 1445%
Wissahickon Hospice $74 1445%
Healthamerica/Coventry $83 - $91 1621%
Olympus $88 1719%
First Health Global $92 1797%
Urn-Cancer Resource Services $92 1797%
Health Net $111 2168%
Pgm - Royal Embassy Of Saudi Arabia $111 2168%
Pgm - Embassy Of Qatar $120 2344%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $120 2344%
Pgm - Embassy Of The United Emirates/Ipc $130 2539%
Devon Health Services Inc $148 2891%
Health America/Ccn $148 2891%
Intergroup $148 2891%
Pgm - Kuwait Health Division $148 2891%
Pgm - Kuwait Oil $148 2891%
Preferred Care $148 2891%
Commercial Other $185 3613%
International Pfs $185 3613%
Magellan $185 3613%
Quest Behavioral Health $185 3613%
United Behavioral Health $185 3613%
Workers Compensation $185 3613%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals