CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Pennsylvania Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $41
  • Cash Discount Price: $136
  • vs. Medicare Baseline: 8.01x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Pennsylvania Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.01x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$136

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $136 (2656%)
Insurance Median: $41 (801%)
Cash: $136 (2656% of Medicare)
Ins. Median: $41 (801% 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 801% of the Medicare baseline (a markup of 701%). 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 - $136 39%
Ibc Commercial Hpn $2 39%
Keystone Hmo Proactive $2 39%
Cigna $3 - $46 59%
Aetna $5 - $136 98%
Geisinger Health Plan $5 - $16 98%
Health Partners $5 - $136 98%
Humana $5 - $109 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 - $136 98%
Upmc $5 - $136 98%
Clover Health Plan $6 117%
Gateway Health Plan $6 117%
Keystone First $6 117%
Medicaid / KanCare $6 - $136 117%
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 $8 156%
Centivo $9 176%
Oscar Health Plan $9 176%
Elap Services $10 195%
Highmark $11 215%
Penn Global Medicine $14 273%
Horizon Nj Health $23 - $24 449%
Pgm - Regie De L'Assurance Maladie Quebec $31 605%
Preferred Health Care Eliance $35 684%
Pgm - Kuwait Defense $48 - $61 938%
Devon $52 - $61 1016%
Qualcare $52 1016%
Coventry $54 - $69 1055%
Pgm - Chop $54 1055%
Wissahickon Hospice $54 1055%
Healthamerica/Coventry $61 - $67 1191%
Olympus $66 1289%
First Health Global $68 1328%
Urn-Cancer Resource Services $68 1328%
Health Net $82 1602%
Pgm - Royal Embassy Of Saudi Arabia $82 1602%
Pgm - Embassy Of Qatar $88 1719%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $88 1719%
Pgm - Embassy Of The United Emirates/Ipc $95 1855%
Devon Health Services Inc $109 2129%
Health America/Ccn $109 2129%
Intergroup $109 2129%
Pgm - Kuwait Health Division $109 2129%
Pgm - Kuwait Oil $109 2129%
Preferred Care $109 2129%
Commercial Other $136 2656%
Community Behavioral Health $136 2656%
International Pfs $136 2656%
Quest Behavioral Health $136 2656%
United Behavioral Health $136 2656%
Workers Compensation $136 2656%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals