Blood test, creatinine (kidney)
Facility: Kansas City Orthopaedic Institute
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $33
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 6.45x 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 645% of the Medicare baseline (a markup of 545%). 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 |
|---|---|---|
| Cigna | $5 - $51 | 98% |
| UnitedHealthcare | $5 - $60 | 98% |
| Aetna | $5 | 98% |
| Blue Cross Blue Shield | $10 - $66 | 195% |
| Medica | $34 - $56 | 664% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rate of $33.00 is significantly lower than the state average, which sits at $56.00. While the facility's gross charge is $64.00, commercial payers like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $34.00 to $66.00, with most plans falling between $5.00 and $60.00. It is important to note that while insurance often provides a ceiling on costs, the cash price for this service is not listed, meaning patients with high-deductible plans might find the negotiated rate more beneficial than a potential cash discount if one exists.
To maximize savings, patients should verify their specific plan's deductible status before scheduling, as paying the negotiated rate may not be covered until that threshold is met. Additionally, asking the hospital directly about "self-pay" or "prompt-pay" discounts is crucial, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. Since the facility is an acute care hospital owned by physicians, patients should also request a full itemized bill to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit dispute.