CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Guadalupe Regional Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $38
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 7.42x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Guadalupe Regional Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 7.42x the Medicare baseline. Located in 1215 E Court St, Seguin, TX.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $57 (1113%)
Insurance Median: $38 (742%)
Cash: $57 (1113% of Medicare)
Ins. Median: $38 (742% 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 742% of the Medicare baseline (a markup of 642%). 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
Aetna $5 - $100 98%
Christus Exchange Health Plan $5 98%
Mcr Clover Health $5 98%
Mcr Texas Independence Health $5 98%
Mcr Wellcare $5 98%
Oscar Health Plan $5 98%
Va Triwest Health Alliance $5 98%
Blue Cross Blue Shield $34 - $38 664%
Superior Hlth Plan Mmcd $51 - $53 996%
Healthcare Highways $85 - $88 1660%
UnitedHealthcare $85 - $88 1660%
Humana $96 - $100 1875%
Cigna $102 - $106 1992%
Texas Mutual Insurance Co $102 - $106 1992%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1215 E Court St, Seguin, TX 78155
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals