CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: St Mary Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $9
  • Cash Discount Price: $51
  • vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at St Mary Medical Center is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 1.76x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$51

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $51 (996%)
Insurance Median: $9 (176%)
Cash: $51 (996% of Medicare)
Ins. Median: $9 (176% 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.

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
Aetna $5 - $69 98%
Align Senior Care $5 98%
Blue Cross Blue Shield $5 - $15 98%
Cigna $5 - $27 98%
Medicare (plans) $5 - $9 98%
Amerihealth $6 117%
Blue Shield - Ca $6 117%
Blue Shield - Id (Regence) $6 117%
Blue Shield - Ny Highmark Western $6 117%
Blue Shield - Wa (Regence) $6 117%
Health America Advantra $6 117%
Medicaid / KanCare $7 - $15 137%
Pace-Trinity Health $8 156%
Ambetter / Centene $9 176%
Jefferson Health Plan Commercial $9 176%
Oscar $9 176%
Prime Healthcare $9 176%
Homestead Health Plans Woods Center $10 195%
UnitedHealthcare $11 - $38 215%
Group Pension Administrators $12 234%
Reedman Toll $12 234%
Blue Shield - Pa (Highmark) $14 273%
Keystone First $15 293%
Keystone First Chip $15 293%
Upmc Health Plan $27 527%
Webtpa $27 527%
Geha $32 625%
Meritain $69 1348%
Multiplan $70 1367%
Prime Health Services $70 1367%
Galaxy Health Network $74 1445%
Three Rivers Provider Network $74 1445%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals