CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Margaretville Memorial Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82565
Insurance Median: $46
Cash Discount Price: $105
vs. Medicare Baseline: 8.98x Medicare

The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Margaretville Memorial Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.98x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $105 (2051%)

Insurance Median: $46 (898%)

Cash: $105 (2051% of Medicare)

Ins. Median: $46 (898% 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 898% of the Medicare baseline (a markup of 798%). 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
Oxford	$8	156%
UnitedHealthcare	$8 - $46	156%
Aetna	$14 - $105	273%
Mvp	$22	430%
Mvp Hmo/Ppo	$26	508%
Blue Cross Blue Shield	$30 - $46	586%
Self-Pay	$43	840%
Mvp Gold (McR)	$46	898%
Medicare (plans)	$46 - $69	898%
Hamaspik (McR)	$46	898%
Affinity By Molina McR	$49	957%
Cdphp	$51	996%
Emblem Ghi/Hip Ppo/Cbp	$65	1270%
Mvp Exchange	$68	1328%
Emblem Select Care (Exchange)	$71	1387%
Oxford Exchange	$74	1445%
Magnacare Standard	$74	1445%
Todays Options	$76	1484%
Emblem Ghi/Hip Hmo/Epo/Pos	$84	1641%
Multiplan	$86	1680%
First Health	$94	1836%
Magnacare Preferred	$415	8105%

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 $105.
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 Margaretville 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.