Blood test, creatinine (kidney)
Facility: Nmc Health
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $40
- Cash Discount Price: $43
- vs. Medicare Baseline: 7.81x 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 781% of the Medicare baseline (a markup of 681%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $11 | 215% |
| Aetna | $16 - $51 | 313% |
| Wppa | $34 | 664% |
| Occunet | $37 | 723% |
| Samaritan Ministries International | $40 | 781% |
| Medincrease Health Plan | $40 | 781% |
| Prime Health Services | $47 | 918% |
| UnitedHealthcare | $56 | 1094% |
| Cigna | $59 | 1152% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Nmc Health in Newton, KS, the facility's cash median price of $43.00 is notably lower than the state average, which sits at $62.00. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $11 to $59, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. If you have a high-deductible plan or have not yet met your deductible, paying the cash rate of $43.00 upfront could save you money compared to the higher negotiated rates your insurer might apply. We recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if you settle the bill in full before or shortly after your visit.
To understand the true cost of this service, it is helpful to compare the facility's pricing against the federal Medicare benchmark. The Medicare amount for this procedure is $5.12, which serves as an objective baseline for fair pricing. The facility's cash rate of $43.00 represents a markup of 7.8 times the Medicare amount, which is significantly higher than the typical fair pricing range of 120% to 150% of Medicare. When reviewing your bill, ensure you receive an itemized statement rather than a summary to verify that no unbundled codes or services not rendered have inflated the total. If you receive a balance bill from an out-of-network provider at this in-network facility, you may be entitled to protections under the No Surprises Act, so do not pay immediately without disputing the charge with your insurer.