CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Prosser Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $78
Cash Discount Price: $54
vs. Medicare Baseline: 15.23x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Prosser Memorial Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 15.23x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $54 (1055%)

Insurance Median: $78 (1523%)

Cash: $54 (1055% of Medicare)

Ins. Median: $78 (1523% 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 1523% of the Medicare baseline (a markup of 1423%). 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
UnitedHealthcare	$9 - $40	176%
Kaiser Permanente	$20 - $89	391%
Community Health Plan Of Washington	$21 - $40	410%
Coordinated Care	$21 - $40	410%
Amerigroup	$22 - $42	430%
Molina	$22 - $40	430%
Health Alliance Northwest	$24	469%
Wellcare	$24	469%
Humana	$25 - $83	488%
Aetna	$29 - $83	566%
Ambetter / Centene	$69 - $75	1348%
Asuris	$78 - $88	1523%
Health Management Adminstrators	$78 - $88	1523%
Premera	$78	1523%
Regence	$78 - $88	1523%
Cigna	$80	1563%
First Choice	$83	1621%
Multiplan	$83 - $88	1621%

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 $54.
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 Prosser Memorial Hospital 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.