CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Spotsylvania Regional Medical Center

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $21
  • Cash Discount Price: $216
  • vs. Medicare Baseline: 4.10x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Spotsylvania Regional Medical Center is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 4.10x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.
Cash / Self-Pay
$216

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $216 (4219%)
Insurance Median: $21 (410%)
Cash: $216 (4219% of Medicare)
Ins. Median: $21 (410% 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 410% of the Medicare baseline (a markup of 310%). 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 98%
Align Senior Care $5 98%
Blue Cross Blue Shield $5 - $27 98%
Cigna $5 - $25 98%
Clear Spring Health Plan $5 98%
Devoted $5 98%
Evernorth Behavioral Health $5 98%
Humana $5 98%
Johns Hopkins $5 98%
Sentara Health $5 98%
United $5 - $97 98%
United Behavioral Health $5 98%
Virginia Premier Health $5 98%
Bright Health $11 215%
Lifeworks $41 801%
Virginia Health Network $76 - $140 1484%
Kaiser $127 2480%
Greenvbrier Sporting Club $130 2539%
Multiplan $153 2988%
Corvel $156 3047%
Occunet Workers Comp $173 3379%
4Most Health Nework $194 3789%
Three Rivers Provider Network $194 3789%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 Spotsylvania Parkway, Fredericksburg, VA 22408
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals