CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $41
Cash Discount Price: $44
vs. Medicare Baseline: 8.01x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Texas Childrens Hospital North Austin Campus is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.01x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $44 (859%)

Insurance Median: $41 (801%)

Cash: $44 (859% of Medicare)

Ins. Median: $41 (801% 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 801% of the Medicare baseline (a markup of 701%). 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
Superior Chip	$5	98%
Driscoll Children'S Health Plan Mcd	$6	117%
Community Health Choice	$9 - $54	176%
First Care Health Plan	$15 - $54	293%
UnitedHealthcare	$15 - $54	293%
Molina Mcd	$16 - $25	313%
Blue Cross Blue Shield	$19 - $53	371%
Community First Health Plan Mcd	$22 - $34	430%
Cook Children'S Health Plan	$22 - $34	430%
Cigna	$31 - $54	605%
Aetna	$35 - $54	684%
Kelseycare	$35 - $55	684%
Healthsmart	$38 - $59	742%
Evolutions Healthcare	$40 - $63	781%
First Health	$48 - $80	938%
Multiplan	$49 - $76	957%
Galaxy Health Network	$51 - $80	996%

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 $44.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82565.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Texas Childrens Hospital North Austin Campus is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82565.
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.