CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: UPMC Kane

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $28
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at UPMC Kane is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 5.47x the Medicare baseline. Located in 4372 Route 6, Kane, PA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $46 (898%)
Insurance Median: $28 (547%)
Cash: $46 (898% of Medicare)
Ins. Median: $28 (547% 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 547% of the Medicare baseline (a markup of 447%). 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
UPMC Work Partners $5 98%
Focus Healthcare $6 - $73 117%
UnitedHealthcare $7 - $31 137%
Aetna $7 - $30 137%
UPMC Health Plan $7 - $34 137%
Geisinger $9 176%
Highmark Wholecare (Prev Gateway) $10 - $31 195%
Amerihealth Caritas $10 - $31 195%
PA Health & Wellness $11 215%
Blue Cross Blue Shield $22 - $28 430%
Horizon Health Plan $54 1055%
Cigna $54 - $1,733 1055%
Multiplan $58 1133%
Intergroup $62 1211%
Health Coalition Partners $62 1211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4372 Route 6, Kane, PA 16735
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals