Blood test, creatinine (kidney)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $5
- Cash Discount Price: $38
- 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 |
|---|---|---|
| United Mine Workers Of America | $5 | 98% |
| UnitedHealthcare | $5 - $6 | 98% |
| Aetna | $5 - $6 | 98% |
| Blue Cross Blue Shield | $5 | 98% |
| Humana | $5 | 98% |
| Providrs Care Network | $5 | 98% |
| Lantern Specialty Care | $8 | 156% |
Consumer Guidance & Cost Commentary
For the CPT code 82565, representing a blood test for creatinine (kidney), Kansas Spine & Specialty Hospital, Llc in Wichita, KS, lists a gross charge of $58.00. The facility's cash median price is $38.00, which is significantly lower than the gross charge and may offer savings for patients with high-deductible plans or those without insurance. While the data does not provide a specific state or county average for this service, the cash rate of $38.00 serves as a direct benchmark for self-pay patients. It is important to note that commercial insurance negotiated rates, such as the $5.00 median negotiated rate shown here, are often lower than cash prices due to administrative costs and contract structures; however, patients should verify their specific plan's allowed amount, as some policies may cover the full negotiated rate while others require the patient to pay the difference after meeting their deductible.
Patients should be aware of potential balance billing risks if they receive care from out-of-network providers, even at an in-network hospital, particularly for ancillary services like laboratory tests. Under the No Surprises Act, balance billing for emergency care and non-emergency services at in-network facilities is prohibited, but patients should still review their itemized bills to ensure no unexpected charges exist. If a patient chooses to pay out-of-pocket, they should explicitly request a "self-pay" or "prompt-pay" discount at the time of scheduling, as hospitals often offer fee reductions for upfront payments that bypass the costly insurance claims process. Additionally, patients should demand a full itemized bill before agreeing to any payment plan, as summary bills can obscure errors or unbundled charges