Blood test, creatinine (kidney)
Facility: Lane County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $40
- Cash Discount Price: $40
- vs. Medicare Baseline: 7.81x 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 781% of the Medicare baseline (a markup of 681%). 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 | $36 - $40 | 703% |
| Aetna | $36 - $38 | 703% |
| Healthy Blue Mcr Adv - All Other Plans | $40 | 781% |
| Healthy Blue Mcaid | $40 | 781% |
| Medicaid / KanCare | $40 - $44 | 781% |
| Wppa Providers-All Plans | $60 | 1172% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Lane County Hospital in Dighton, Kansas, the cash price is $40.00, which matches the facility's negotiated rate with all six listed payers, including UnitedHealthcare, Aetna, and Medicaid/KanCare. This price is notably higher than the state average for this service, which is $5.12, and significantly exceeds the Medicare benchmark of $5.12. While commercial insurance contracts often result in higher allowed amounts due to administrative costs and network tiering, the fact that the negotiated rate equals the cash price here suggests no balance billing risk for in-network patients. However, patients with high-deductible plans should consider that paying the $40.00 cash price upfront might be more cost-effective if their insurance allowed amount exceeds this figure, as they would avoid paying their deductible or copay on top of the service cost.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify that all ancillary services, such as specific lab components, are properly classified to avoid unexpected fees. Additionally, since the facility is a Critical Access Hospital owned by a government hospital district, you should explicitly ask about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount if paid in full within 30 days. These discounts bypass the standard insurance claims cycle, saving the facility