Blood test, creatinine (kidney)
Facility: Grisell Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $15
- Cash Discount Price: $25
- vs. Medicare Baseline: 2.93x 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 293% of the Medicare baseline (a markup of 193%). 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 |
|---|---|---|
| UnitedHealthcare | $1 - $20 | 20% |
| Blue Cross Blue Shield | $10 | 195% |
| Medicaid / KanCare | $26 | 508% |
| Humana | $26 | 508% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Grisell Memorial Hospital in Ransom, KS, the facility's cash price of $25.00 is slightly lower than the state average but aligns closely with the county average. While the hospital's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range between $10 and $26, the cash price remains competitive. It is important to note that for patients with high-deductible plans, paying the cash price of $25.00 upfront may be more cost-effective than relying on insurance, as commercial negotiated rates often include administrative overhead that can exceed the direct cash cost. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if settled in full before or shortly after the service.
The facility's allowed amount under Medicare is $5.12, which serves as a critical benchmark for evaluating the true cost of this service. The commercial negotiated rates for this procedure are significantly higher than the Medicare rate, reflecting the standard markup found in commercial contracts. To ensure you are not overcharged, we recommend requesting a detailed, itemized bill that breaks down every CPT code and unit cost, as summary bills often obscure individual charges. If you receive a bill that includes unexpected charges from out-of-network services, such as emergency physicians or lab components, you may be entitled to protections under the No Surprises Act, which prohibits balance billing for these specific scenarios. Always dispute any summary bills immediately and request a full line-item audit to identify potential errors or unbundled codes before making a payment.