CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Tristar Southern Hills Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $49
  • Cash Discount Price: $285
  • vs. Medicare Baseline: 9.57x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Tristar Southern Hills Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 9.57x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.
Cash / Self-Pay
$285

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $285 (5566%)
Insurance Median: $49 (957%)
Cash: $285 (5566% of Medicare)
Ins. Median: $49 (957% 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 957% of the Medicare baseline (a markup of 857%). 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
Wellpoint $2 39%
Aetna $4 - $152 78%
Ambetter / Centene $5 - $6 98%
American Health Advantage $5 98%
Amerigroup $5 98%
Blue Cross Blue Shield $5 - $29 98%
Bright Health $5 - $6 98%
Devoted Health Plan $5 98%
Evergreen Hmo $5 98%
Healthspring $5 98%
Humana $5 - $76 98%
Odyssey Healthcare $5 98%
Sarah Cannon Research $5 98%
Signature Advantage $5 98%
United $5 - $137 98%
Wellcare $5 98%
Zing $5 98%
Atrio Golden Times $6 117%
Prime Health $7 - $268 137%
Corvel Corporation $8 156%
Novanet $8 156%
Cigna $9 - $99 176%
Oscar $15 293%
Kentucky Labor Cabinet $49 - $56 957%
Apex Health $51 - $58 996%
Nhc Advantage, Inc. $51 - $58 996%
Pruitt Health (Allyalign) $51 - $58 996%
Centurion $110 - $126 2148%
Bgfh Singlesource $133 - $259 2598%
Multiplan $155 - $177 3027%
Employers Health Network $187 - $214 3652%
Odom'S Tn Pride Sausage $200 - $229 3906%
Beech Street $235 - $268 4590%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 391 Wallace Rd, Nashville, TN 37211
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals