CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: North Austin Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $23
  • Cash Discount Price: $303
  • vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at North Austin Medical Center is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $303. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.49x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$303

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $303 (5918%)
Insurance Median: $23 (449%)
Cash: $303 (5918% of Medicare)
Ins. Median: $23 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
St David’S Hospice $4 - $5 78%
Superior Health Plan $4 - $89 78%
United $4 - $236 78%
Aetna $5 98%
American Health Plan Of Texas $5 98%
Blue Cross Blue Shield $5 - $155 98%
Cigna $5 - $14 98%
Devoted Health $5 98%
Humana $5 98%
Molina Healthcare $5 - $6 98%
Odyssey Hospice $5 98%
Provider Partners Health Plan $5 98%
Pyramid Life $5 98%
Sendero $5 - $9 98%
Shared Health $5 98%
Texas Independent Health Plan $5 98%
Triwest Healthcare Alliance $5 98%
UnitedHealthcare $5 - $236 98%
Wellcare $5 98%
Wellmed $5 98%
Austin Fc $6 117%
Imperial Insurance $6 117%
Triwest Health Alliance $6 117%
Universal Health $6 117%
Amerigroup $7 137%
Naphcare $8 156%
Seven Corners $8 156%
Corvel Corporation $10 195%
Oscar $14 - $16 273%
Moda $19 - $123 371%
Covenant Management Systems $23 - $151 449%
Healthcare Highways $23 - $158 449%
Imo Med - Select Network $24 - $158 469%
Nomi Health $26 - $194 508%
Evry Health $29 - $193 566%
Moda Health $29 - $194 566%
Texas Healthcare Foundation Heb $30 - $194 586%
Texas Workforce Commission $31 - $205 605%
Harbor Health Team $32 - $210 625%
Averde Health $36 - $236 703%
Comanche County $40 - $262 781%
National Choicecare $40 - $262 781%
Healthsmart Preferred Care $44 - $420 859%
Independent Medical Systems $44 - $289 859%
Physicians Cooperative Of Texas $44 - $289 859%
Prime Health $48 - $315 938%
First Health $50 - $373 977%
Coastal Comp Health Networks $52 - $341 1016%
National Health Care $52 - $341 1016%
Texas Municipal League $56 - $368 1094%
Medcorp Southwest $60 - $394 1172%
Rockport Healthcare Group $64 - $472 1250%
Bce Emergis Corporation $72 - $472 1406%
Beech Street $72 - $472 1406%
Medical Control Network Solutions $72 - $472 1406%
Multiplan $72 - $472 1406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals