Blood test, creatinine (kidney)
Facility: Ellinwood District Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $33
- Cash Discount Price: $41
- 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 | $33 | 645% |
| UnitedHealthcare | $33 | 645% |
| Humana | $33 | 645% |
| Aetna | $33 | 645% |
| Blue Cross Blue Shield | $33 | 645% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Ellinwood District Hospital, the cash median price is $41.00, which is lower than the negotiated rate of $33.00 paid by major insurers like Cigna, UnitedHealthcare, Humana, Aetna, and Blue Cross Blue Shield. This price transparency data indicates that paying out-of-pocket directly can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the insurer's negotiated rate exceeds the cash price. While the facility is a Critical Access Hospital in Ellinwood, KS, with a government ownership structure, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible rate, as these upfront incentives can bypass the administrative costs associated with insurance billing.
When evaluating the cost, it is important to compare the facility's rates against objective benchmarks rather than the hospital's inflated chargemaster list. The Medicare amount for this service is $5.12, and the facility's cash rate is 6.4% higher than the Medicare benchmark, which aligns with the typical range for fair pricing (120% to 150% of Medicare). Commercial negotiated rates often average 200% to 300% of Medicare due to administrative overhead, so relying on the Medicare rate provides a scientifically validated baseline for understanding the true cost of care. If you receive a bill that appears higher than expected, you should request an itemized billing audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain inaccuracies that can be corrected through a formal