Blood test, creatinine (kidney)
Facility: St. Catherine Hospital - Garden City
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $18
- Cash Discount Price: $31
- vs. Medicare Baseline: 3.52x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 352% of the Medicare baseline (a markup of 252%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Humana | $5 | 98% |
| Cigna | $5 - $7 | 98% |
| Devoted Health | $5 | 98% |
| Kaiser | $5 - $26 | 98% |
| UnitedHealthcare | $5 - $35 | 98% |
| Innovage | $5 | 98% |
| Kansas Health | $5 | 98% |
| Blue Cross Blue Shield | $5 - $18 | 98% |
| Medicare (plans) | $5 | 98% |
| Aetna | $5 - $48 | 98% |
| Centura Employee Plan | $6 | 117% |
| United Colorado Doctor'S Plan | $8 | 156% |
| Direct To Employer | $9 - $38 | 176% |
| Denver Health | $23 | 449% |
| Peak Health | $37 | 723% |
| Wpaa | $40 | 781% |
| Christian Health Aid | $46 | 898% |
| Multiplan | $51 - $81 | 996% |
| Health Partners Of Kansas | $55 | 1074% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at St. Catherine Hospital in Garden City, Kansas, the cash median price is $31.00, which is significantly lower than the facility's gross charge of $76.00. While many commercial payers negotiate rates that often exceed the cash price—such as Multiplan's range of $51 to $81 and Aetna's range of $5 to $48—patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount is higher than the cash rate. It is important to note that the facility's negotiated average of $18.00 is lower than the cash price, suggesting that for some insured patients, the insurance payment combined with their deductible could result in a lower total cost than paying cash directly. Additionally, the facility's facility rating of 2 indicates a need for further review regarding quality or patient experience metrics.
When comparing pricing to benchmarks, the Medicare amount of $5.12 serves as the most reliable baseline for evaluating the facility's markup, as it reflects the true cost of care rather than inflated list prices. The commercial negotiated rates observed across various payers, ranging from $5 to $81, generally align with the typical commercial range of 200% to 300% of the Medicare rate, though some specific contracts like Denver Health's $23.00 and Peak Health's $37.00 fall within the fair pricing window of 120% to 150% of Medicare. Patients should be aware that balance billing is largely prohibited for emergency services and non-emergency services at in-network facilities under the No