Blood test, creatinine (kidney)
Facility: Wesley Medical Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $8
- Cash Discount Price: $317
- vs. Medicare Baseline: 1.56x 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 |
|---|---|---|
| United | $2 - $278 | 39% |
| Preferred Health Choices | $3 - $117 | 59% |
| Ambetter / Centene | $3 - $111 | 59% |
| Health Partners Of Kansas | $3 - $309 | 59% |
| Wppa | $3 - $108 | 59% |
| Medical Associates Health Plan | $3 - $117 | 59% |
| Humana | $5 | 98% |
| Triwest Health Alliance | $5 | 98% |
| Medicaid / KanCare | $5 | 98% |
| Devoted Health | $5 | 98% |
| Coventry Health Care | $5 | 98% |
| Amerigroup | $5 | 98% |
| Spirit Aerosystems | $5 - $198 | 98% |
| Aetna | $5 - $221 | 98% |
| UnitedHealthcare | $5 | 98% |
| First Health | $7 - $285 | 137% |
| Correct Care Solutions | $8 | 156% |
| Multiplan | $10 - $556 | 195% |
| Triwest Healthcare Alliance | $10 - $402 | 195% |
| Usa Managed Care | $13 - $525 | 254% |
| Blue Cross Blue Shield | $14 | 273% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Wesley Medical Center in Wichita, KS, the cash price is $317.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a comparison factor of 1.6 against Medicare's benchmark rate of $5.12. While commercial insurance plans like United and Aetna have negotiated rates ranging from $2 to $221, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying cash directly can be more affordable than relying on insurance, provided you confirm that the negotiated rate is indeed higher than the self-pay amount.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from being billed for the difference between the provider's full rate and your insurance's allowed amount for emergency or non-emergency services at in-network facilities. Always verify your deductible status and ask for a self-pay classification prior to scheduling to secure the best possible rate.