Blood test, creatinine (kidney)
Facility: Wichita County Health Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $27
- Cash Discount Price: $24
- vs. Medicare Baseline: 5.27x 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 527% of the Medicare baseline (a markup of 427%). 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 |
|---|---|---|
| Medicaid / KanCare | $25 | 488% |
| UnitedHealthcare | $30 | 586% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Wichita County Health Center, the facility's cash price of $24.00 is lower than the median negotiated rate of $27.00 and the state average of $30.00. While Medicaid/KanCare and UnitedHealthcare both pay the full negotiated amount of $25.00 and $30.00 respectively, patients with high-deductible plans might find paying the cash price directly more affordable if their insurance allowed amount exceeds this figure. It is important to note that the facility is a Critical Access Hospital in Leoti, KS, and while the cash rate is competitive, patients should always verify their specific plan's allowed amount before scheduling to ensure they are not being charged the higher negotiated rate.
If you choose to use insurance, be aware that the facility is in-network for both payers, meaning the No Surprises Act protects you from balance billing for emergency care or non-emergency services at this location. However, if you are self-paying, you may be eligible for a prompt-pay discount by asking the billing department for a self-pay rate before check-in, which can reduce the cost further than the listed cash median. Since over 80% of hospital bills contain errors, if you receive an itemized bill, request a full line-by-line audit to identify any unbundled codes or services not rendered, ensuring you only pay for what was actually provided.