Blood test, creatinine (kidney)
Facility: Kansas Heart Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $5
- Cash Discount Price: $23
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Aetna | $3 | 59% |
| Tricare | $5 | 98% |
| UnitedHealthcare | $5 | 98% |
| Celtic Mcr Adv | $5 | 98% |
| Medicaid / KanCare | $5 | 98% |
| Humana | $5 | 98% |
| Blue Cross Blue Shield | $7 | 137% |
| Wppa - All Plans | $7 - $22 | 137% |
| Multiplan - All Plans | $16 - $49 | 313% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Kansas Heart Hospital in Wichita, KS, the facility's cash price of $23.00 is notably higher than the state average, which is $19.00. While the hospital offers a negotiated rate of $5.00 for in-network insurance plans, this amount is significantly lower than the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly, provided they can afford the upfront cost. It is important to note that commercial insurance rates often include administrative overhead and contract markups, which can make them higher than the cash price even though they are lower than the hospital's full chargemaster list.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like laboratory tests are billed separately by out-of-network vendors. To avoid these surprises, consumers should request a full itemized bill before paying and dispute any errors in writing rather than accepting summary invoices. Additionally, asking the hospital for a "prompt-pay" discount before scheduling the test could reduce the final cost, as facilities often offer significant reductions for upfront payments to bypass costly insurance billing cycles.