CMS Price Transparency Data
Blood test, creatinine (kidney)
Facility: Watsonville Community Hospital
Billing Code: 82565 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 82565
- Insurance Median: $486
- Cash Discount Price: $488
- vs. Medicare Baseline: 94.92x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Watsonville Community Hospital is $486. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 94.92x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$488
Average discount available for prompt cash payment at this facility.
Insurance Median
$486
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: $488 (9531%)
Insurance Median: $486 (9492%)
Cash: $488 (9531% of Medicare)
Ins. Median: $486 (9492% 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 9492% of the Medicare baseline (a markup of 9392%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $5 | 98% |
| UnitedHealthcare | $5 - $488 | 98% |
| Veterans Administration | $5 | 98% |
| Keenan & Assoc Work Comp | $5 | 98% |
| Health Net of California | $5 - $510 | 98% |
| Beta Healthcare Group | $5 | 98% |
| Blue Shield PPO | $5 - $16 | 98% |
| U.S. Dept. of Labor | $5 | 98% |
| Fireman's Fund Work Comp | $5 | 98% |
| Workers Comp | $5 | 98% |
| Medicare (plans) | $5 | 98% |
| Liberty Mutual Work Comp | $5 | 98% |
| Miscellaneous Work Comp | $5 | 98% |
| Kemper Group Workers Comp | $5 | 98% |
| Republic Idemnity W/Comp | $5 | 98% |
| Hartford Workers' Comp | $5 | 98% |
| Ace-Usa | $5 | 98% |
| Travelers Insurance | $5 - $813 | 98% |
| Gallagher Bassett Svcs | $5 | 98% |
| Nx Health Network | $5 | 98% |
| Crawford & Co | $5 | 98% |
| Alignment Health Plan | $5 | 98% |
| Western Growers Work Comp | $5 | 98% |
| Pinnacle Healthcare Uc | $5 | 98% |
| Secure Horizons Dign HMO | $5 - $163 | 98% |
| Secure Horizons | $5 | 98% |
| Fleming & Associates | $5 | 98% |
| Medi-Cal/Eds | $6 | 117% |
| Medicaid / KanCare | $6 | 117% |
| Well Path | $6 - $813 | 117% |
| Healthy Families | $6 - $16 | 117% |
| Medi-Cal E.R. | $6 | 117% |
| Ccs/Monterey County | $6 | 117% |
| California Childrens Srvs | $6 | 117% |
| Alliance/Sccho | $7 | 137% |
| United Agriculture | $16 | 313% |
| Bs Employee | $16 | 313% |
| Ufcw/Valley Clerks | $16 | 313% |
| City of Wats/Pinnacle Clm | $34 - $724 | 664% |
| Operating Engineers | $34 - $724 | 664% |
| Western Growers Trust/Bc | $34 - $724 | 664% |
| Carpenters H&W Trust | $34 - $724 | 664% |
| Teamsters Benefit Trust | $34 - $724 | 664% |
| Laborers Health & Welfare | $34 - $724 | 664% |
| Delta Health Systems | $34 - $724 | 664% |
| Sheet Metal Workers | $34 - $724 | 664% |
| Blue Cross Blue Shield | $34 - $724 | 664% |
| State Compensation Fund | $34 - $724 | 664% |
| Monterey Bay Pub Emp Trst | $34 - $724 | 664% |
| Robert Kennedy/Ccn | $34 - $724 | 664% |
| Calif Ironworkers Field | $34 - $724 | 664% |
| Claims Management Wc | $34 - $724 | 664% |
| Pinnacle Claims Tpa/Bc | $34 - $724 | 664% |
| Victim Compensation Plan | $146 - $813 | 2852% |
| Medicruz | $146 | 2852% |
| Pacificare HMO | $163 - $488 | 3184% |
| Great-West/Phcs | $163 - $569 | 3184% |
| Blue Shield HMO | $163 | 3184% |
| Aetna | $163 - $666 | 3184% |
| Health Net Pmg HMO | $163 - $510 | 3184% |
| Cigna | $163 - $569 | 3184% |
| Western Health Advantage | $406 | 7930% |
| Self Pay | $488 | 9531% |
| Health Net Smartcare Netw | $488 | 9531% |
| Pacificare PPO | $488 | 9531% |
| Health Net Blue and Gold | $510 | 9961% |
| Health Net Canopycare HMO | $510 | 9961% |
| First Health | $569 - $650 | 11113% |
| Transwestern | $569 - $650 | 11113% |
| Geha (Ccn) | $569 - $650 | 11113% |
| Adventist Risk Management | $569 - $650 | 11113% |
| Private Healthcare System | $634 | 12383% |
| Multiplan Inc PPO | $634 | 12383% |
| Coastal Healthcare Admin | $691 - $731 | 13496% |
| Salinas Valley Mem Hops | $691 | 13496% |
| Miscellaneous Auto | $813 | 15879% |
| Apwu Health Plan | $813 | 15879% |
| Humana | $813 | 15879% |
| Zenith National Ins | $813 | 15879% |
| Allstate | $813 | 15879% |
| Miscellaneous Insurance | $813 | 15879% |
| Prucare Pmg POS | $813 | 15879% |
| Aaa | $813 | 15879% |
| Sutter Health Plus | $813 | 15879% |
| State Farm Ins | $813 | 15879% |
| Prucare Pmg HMO | $813 | 15879% |
| Aarp | $813 | 15879% |
| Bankers Life & Casualty | $813 | 15879% |
| Farmers Insurance | $813 | 15879% |
| Physicians Mutual | $813 | 15879% |
| United Administrative | $813 | 15879% |
| Wholesale Beer Distributo | $813 | 15879% |
| North Calif Bakery Driver | $813 | 15879% |