Blood test, creatinine (kidney)
Facility: Mcpherson Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $25
- Cash Discount Price: $23
- vs. Medicare Baseline: 4.88x 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 488% of the Medicare baseline (a markup of 388%). 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 | $5 | 98% |
| Humana | $5 | 98% |
| Healthy Blue Mcr Adv | $5 | 98% |
| Wellcare Mcr Adv - All Plans | $5 | 98% |
| Va Ccn - All Plans | $5 | 98% |
| UnitedHealthcare | $5 - $90 | 98% |
| Tricare | $5 | 98% |
| Ambetter / Centene | $6 | 117% |
| Wppa - All Plans | $18 - $63 | 352% |
| Central Plains - All Plans | $19 - $68 | 371% |
| Medical Associates - All Plans | $19 - $68 | 371% |
| Christian Health Aid - All Plans | $20 - $72 | 391% |
| Aetna | $21 - $90 | 410% |
| Multiplan - All Plans | $22 - $81 | 430% |
| Cigna | $24 - $86 | 469% |
| First Health - All Plans | $24 - $86 | 469% |
| Health Partners - All Plans | $24 - $86 | 469% |
| Medicaid / KanCare | $25 - $90 | 488% |
| Health Blue Mcaid - All Other Plans | $26 - $92 | 508% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at McPherson Hospital in McPherson, Kansas, the facility's cash median price is $23.00, which is lower than the state average of $24.00. While the facility's negotiated rates for commercial payers range from $5.00 to $92.00 depending on the specific insurance plan, these amounts are generally higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash rate. It is important to verify the specific allowed amount for your plan before scheduling, as in-network rates vary significantly by carrier and can sometimes be much higher than the cash price.
The facility's billing practices align with standard industry benchmarks, with a Medicare amount of $5.12 serving as the baseline for comparison. The facility's negotiated rates average $25.00, which is slightly higher than the Medicare benchmark, reflecting typical commercial markup dynamics. To minimize costs, patients should proactively request a "self-pay" or "prompt-pay" discount before check-in, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass expensive claims processing. Additionally, if you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit to identify errors, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written dispute.