Blood test, creatinine (kidney)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $8
- Cash Discount Price: $73
- vs. Medicare Baseline: 1.56x 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 |
|---|---|---|
| First Health Contracted [320128] | $4 | 78% |
| United Medical Resources Contracted [320454] | $4 - $14 | 78% |
| UnitedHealthcare | $4 - $104 | 78% |
| Aetna | $4 - $5 | 78% |
| Qual Choice Contracted [320325] | $5 | 98% |
| Kindful Hospice [20434] | $5 | 98% |
| Mercy Mgd Behavioral Health Contracted [320259] | $5 | 98% |
| Blue Cross Blue Shield | $5 - $8 | 98% |
| Medicare (plans) | $5 | 98% |
| Cross Timbers Hospice [20098] | $5 | 98% |
| Halo Hcr Inc Hospice [20432] | $5 | 98% |
| Kindful Hospice Contracted [320434] | $5 | 98% |
| Medical Associates Health Contracted [320444] | $5 | 98% |
| Medicaid / KanCare | $5 - $7 | 98% |
| Mercy Hospice Okc [20252] | $5 | 98% |
| Tricare | $5 | 98% |
| Cigna | $5 - $30 | 98% |
| Dept Of Veteran Affairs Contracted [320106] | $5 | 98% |
| Pace Of The Ozarks Contracted [320518] | $5 | 98% |
| Elara Caring Aspire Hospice [20433] | $5 | 98% |
| Humana | $5 | 98% |
| Globalhealth Contracted [320145] | $5 | 98% |
| Cherokee Nation Health Serv Contracted [320066] | $5 | 98% |
| Medica Contracted [320239] | $5 | 98% |
| Halo Hcr Inc Hospice Contracted [320432] | $5 | 98% |
| Provider Partners Health Plans Contracted [320450] | $6 | 117% |
| Centivo Contracted [320505] | $8 | 156% |
| Providrs Care Network Contracted [320484] | $10 | 195% |
| Insurance System Inc Contracted [320465] | $14 | 273% |
| Benefit Management Contracted [320052] | $14 | 273% |
| Healthscope Contracted [320182] | $14 - $84 | 273% |
| Health Systems Inc Contracted [320174] | $14 | 273% |
| Point C Contracted [320238] | $14 - $84 | 273% |
| Show-Me Health Administrators Contracted [320483] | $31 | 605% |
| Mercy Benefit Admin Contracted [320251] | $31 - $78 | 605% |
| Reflect Health Contracted [320492] | $78 | 1523% |
| American Healthcare Alliance Contracted [320020] | $78 | 1523% |
| Auxiant Contracted [320462] | $78 - $84 | 1523% |
| Yuzu Health Contracted [320521] | $78 | 1523% |
| Aither Health Contracted [320449] | $78 | 1523% |
| Imagine 360 Contracted [320494] | $78 | 1523% |
| Ebms Contracted [320493] | $78 | 1523% |
| Edison Health Solutions Contracted [320502] | $78 | 1523% |
| Preferred Health Plan Contracted [320522] | $84 | 1641% |
| Federal Medical Center Contracted [320127] | $84 | 1641% |
| Healthlink Contracted [320179] | $84 | 1641% |
| Compcare Of The Ozarks Contracted [320437] | $88 | 1719% |
| Workers Comp [20426] | $90 | 1758% |
| Private Health Care Systems Contracted [320320] | $104 | 2031% |
| Multiplan [20270] | $106 | 2070% |
| Multiplan Contracted [320270] | $106 | 2070% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Mercy Specialty Hospital Southeast Kansas, the cash median price is $73.00, which is significantly lower than the negotiated rates paid by most insurance plans. While the facility's cash price is notably lower than the gross charge of $112.00, many commercial payers negotiate rates that average around $8.00 to $104.00 depending on the specific plan, often exceeding the cash amount due to administrative costs and contract structures. Patients with high-deductible plans or those who have not yet met their out-of-pocket maximum may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates can sometimes be higher than the self-pay rate. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, which could further reduce the final amount owed.
The facility's pricing is evaluated against the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. The Medicare allowed amount for this procedure is $5.12, and the facility's cash rate of $73.00 represents a markup relative to this federal standard, consistent with how commercial rates often exceed Medicare benchmarks. Because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients should be aware that unexpected bills for this test are unlikely if the facility is in-network with their insurer. However, if a patient receives a bill for the difference between the provider's charge and the insurance payment, they should request an itemized audit to verify that no unbundled codes or services not rendered are included, ensuring they are not paying for unnecessary charges.