CMS Price Transparency Data

Blood test, calcium

Facility: Children's Hospital of Philadelphia

Billing Code: 82310 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82310
Insurance Median: $196
Cash Discount Price: $467
vs. Medicare Baseline: 37.98x Medicare

The contracted insurance negotiated median rate for a Blood test, calcium at Children's Hospital of Philadelphia is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $5.16, this hospital’s rate is 37.98x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$467

Average discount available for prompt cash payment at this facility.

Insurance Median

$196

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$5.16

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.16 (100%)

Cash / Self-Pay: $467 (9050%)

Insurance Median: $196 (3798%)

Cash: $467 (9050% of Medicare)

Ins. Median: $196 (3798% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.16 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 3798% of the Medicare baseline (a markup of 3698%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Geisinger Medical Assistance	$10	194%
Highmark Wholecare	$11	213%
Horizon Nj Health	$11	213%
Medicaid / KanCare	$77	1492%
UnitedHealthcare	$78 - $257	1512%
Health Partners	$88	1705%
Aetna	$110 - $234	2132%
Upmc Medical Assistance	$128	2481%
Keystone First Chip	$145	2810%
Keystone Health Plan East	$148	2868%
Blue Cross Blue Shield	$165 - $187	3198%
Geisinger Health Plan Commercial	$206	3992%
Jefferson Health Plans	$221	4283%
Cigna	$234	4535%
Highmark	$234	4535%
Qualcare	$257	4981%
First Health Network	$304	5891%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$374	7248%
Private Health Care Systems	$374	7248%
Choice Care Network	$421	8159%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $467.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82310.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Children's Hospital of Philadelphia is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82310.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.