CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Childrens Hospital of Wisconsin

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $72
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 14.06x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Childrens Hospital of Wisconsin is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 14.06x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$72

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: $50 (977%)
Insurance Median: $72 (1406%)
Cash: $50 (977% of Medicare)
Ins. Median: $72 (1406% 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 1406% of the Medicare baseline (a markup of 1306%). 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
Chorus Community Health Plan $5 98%
My Choice Wisconsin $5 - $6 98%
UnitedHealthcare $5 - $69 98%
Blue Cross Blue Shield $6 - $86 117%
Icare $6 117%
Managed Health Services $6 117%
Molina Healthcare Of Wisconsin $6 117%
Froedtert Health $63 - $77 1230%
Medical College Of Wisconsin $63 1230%
Network Health Plan $64 1250%
Aspirus Health Plan $68 1328%
Common Ground Healthcare Cooperative $68 - $77 1328%
Trilogy Health Solutions $68 - $77 1328%
Advocate Aurora Healthcare $69 1348%
Wps Health Plan $69 - $81 1348%
Centivo $70 1367%
Health Partners $70 - $79 1367%
Employer Health Care Alliance Cooperative $71 1387%
Dean Health Plan $72 1406%
Group Health Cooperative Of Eau Claire $72 1406%
Oan Llc $72 1406%
Security Health Plan $75 1465%
Health Payment Systems $76 1484%
Praire States $77 1504%
Quartz Health Insurance $77 1504%
Sheboygan Employer'S Health Network $77 1504%
Aetna $79 - $80 1543%
Mayo Clinic Health Solutions $79 1543%
Bellin Thedacare $81 1582%
Cigna $81 1582%
Group Health Cooperative Of South Central Wisconsin $81 1582%
Prevea Health Network $81 1582%
Multiplan $82 - $86 1602%
Coventry Health Care $86 1680%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens