Blood test, creatinine (kidney)
Facility: Kansas Medical Center Llc
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $5
- Cash Discount Price: $33
- 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 | $3 | 59% |
| Blue Cross Blue Shield | $5 - $12 | 98% |
| Ambetter / Centene | $5 | 98% |
| Medicaid / KanCare | $5 | 98% |
| Indian Health | $5 | 98% |
| Humana | $5 | 98% |
| Medadv_Wellcare | $5 | 98% |
| Three_Rivers | $10 | 195% |
| Aetna | $16 | 313% |
| Wppa | $22 | 430% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Kansas Medical Center Llc in Andover, the cash median price is $33.00, which is significantly lower than the facility's gross charge of $55.00. While the facility's negotiated rate with insurance payers averages $5.00, this amount is higher than the cash price, meaning patients with high-deductible plans or those without insurance may save money by paying the $33.00 cash rate directly. It is important to note that the facility's negotiated rate of $5.00 is slightly higher than the state average of $5.12 for Medicare, and the facility's overall rating is 2 out of 5. Patients should verify their specific plan details, as some commercial payers may have different allowed amounts that could result in lower out-of-pocket costs than the cash price.
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 lab tests are billed separately. If you receive a bill that seems too high, request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing. Always ensure you are reviewing the final itemized statement before signing any consent waivers that might waive your rights to dispute out-of-network charges.