Blood test, creatinine (kidney)
Facility: Stormont Vail Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $9
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.76x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $5 - $11 | 98% |
| Ambetter / Centene | $5 | 98% |
| UnitedHealthcare | $5 | 98% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Stormont Vail Hospital in Topeka, KS, the median amount paid by insurance is $3,185.00, which is 1.8 times the Medicare benchmark amount of $5.12. This facility is a voluntary non-profit acute care hospital located in Topeka (ZIP 66604), and while the data does not provide specific cash or negotiated rates for this service, the significant markup relative to Medicare suggests that commercial insurance rates can be substantially higher than the federal baseline. Patients should be aware that assuming an in-network rate is the lowest possible price is a common pitfall, as different insurers within the same network may negotiate different ceilings, and some facilities charge significantly more than others for the same code.
To potentially lower costs, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as paying upfront can sometimes bypass the administrative overhead and multi-layered structures that inflate insurance rates. It is important to check your deductible status before using insurance, as high negotiated rates may be charged even if you have not yet met your plan's deductible. Additionally, while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should request a full itemized CPT-coded bill to identify any errors, double-billing, or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.