CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: St Christopher's Hospital for Children

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $84
  • Cash Discount Price: $209
  • vs. Medicare Baseline: 16.41x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at St Christopher's Hospital for Children is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 16.41x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.
Cash / Self-Pay
$209

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $209 (4082%)
Insurance Median: $84 (1641%)
Cash: $209 (4082% of Medicare)
Ins. Median: $84 (1641% 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 1641% of the Medicare baseline (a markup of 1541%). 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 $4 - $227 78%
Amerihealth Caritas $6 117%
Horizon Nj Health $6 117%
UnitedHealthcare $6 - $10 117%
Cigna $8 156%
Geisinger $8 - $188 156%
Pa Health & Wellness $9 176%
Aetna $11 - $314 215%
Upmc $12 234%
Gateway $14 273%
Health Partners $94 1836%
Wellpoint Nj (Formerly Amerigroup) $111 2168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 160 East Erie Ave, Philadelphia, PA 19134
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Childrens