Blood test, creatinine (kidney)
Facility: Pratt Regional Medical Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $22
- Cash Discount Price: $19
- vs. Medicare Baseline: 4.30x 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 430% of the Medicare baseline (a markup of 330%). 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 |
|---|---|---|
| Christian Health Aid | $11 - $28 | 215% |
| UnitedHealthcare | $12 - $38 | 234% |
| Health Partners Of Kansas | $13 - $31 | 254% |
| Aetna | $14 - $33 | 273% |
| Choicecare | $15 - $37 | 293% |
Consumer Guidance & Cost Commentary
For the CPT code 82565, representing a blood test for creatinine (kidney function) at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price is $19.00. This cash rate is notably lower than the facility's negotiated rates, which range from $11 to $38 depending on the insurance carrier. While the facility's negotiated rates are higher than the cash price, patients with high-deductible plans may find paying the $19.00 cash rate more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that the facility's negotiated rates are significantly higher than the Medicare benchmark of $5.12, reflecting the typical markup in commercial insurance contracts.
When evaluating the cost of this service, it is crucial to compare the facility's pricing against broader market standards. The cash median of $19.00 is higher than the state average for this procedure, though specific county averages were not provided in the data. Patients should be aware that while the facility offers a cash rate, they may still face balance billing if their insurance does not cover the service or if ancillary services are out-of-network, despite the No Surprises Act protections for emergency care. To minimize costs, patients are encouraged to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total amount owed. Always request a detailed, itemized bill to verify that no services were unbundled or double-charged, ensuring the final charge aligns with the negotiated or cash rates discussed.