Blood test, creatinine (kidney)
Facility: Lmh
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $72
- Cash Discount Price: $31
- vs. Medicare Baseline: 14.06x 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 1406% of the Medicare baseline (a markup of 1306%). 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 |
|---|---|---|
| Allwell | $5 | 98% |
| Blue Cross Blue Shield | $5 - $82 | 98% |
| Cigna | $5 - $85 | 98% |
| Humana | $5 | 98% |
| Haskell Indian Health Services | $5 | 98% |
| UnitedHealthcare | $5 - $46 | 98% |
| Medicare (plans) | $5 | 98% |
| Aetna | $6 - $106 | 117% |
| Ambetter / Centene | $8 | 156% |
| Non Contracted | $96 - $102 | 1875% |
| First Health | $112 - $118 | 2188% |
Consumer Guidance & Cost Commentary
For the blood test code 82565 (creatinine), the facility's cash median price of $31.00 is significantly lower than the state of Kansas average, which sits at $72.00. While many commercial payers have negotiated rates ranging from $5 to $118, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the $31.00 figure represents a substantial discount compared to the typical negotiated amounts charged to insured members.
It is important to note that Medicare rates for this service are set at $5.12, serving as a baseline for fair pricing rather than a target for commercial negotiations. Commercial rates frequently exceed this benchmark, reflecting the added complexity of insurance billing cycles. To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill. Additionally, if any out-of-network services are rendered during your visit, be aware of federal protections under the No Surprises Act that may prevent balance billing for emergency or non-emergency care at in-network facilities.