Blood test, creatinine (kidney)
Facility: Rawlins County Health Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $30
- Cash Discount Price: $30
- vs. Medicare Baseline: 5.86x 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 586% of the Medicare baseline (a markup of 486%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $11 | 215% |
| UnitedHealthcare | $30 | 586% |
Consumer Guidance & Cost Commentary
For the CPT code 82565, representing a blood test for creatinine (kidney function), Rawlins County Health Center in Atwood, KS, lists a cash median price of $30.00 and a median negotiated rate of $30.00. This facility, a critical access hospital, reports a gross charge of $35.00. When compared to the national benchmark, the facility's pricing is 5.9% higher than the Medicare amount of $5.12. While the data does not provide a specific state or county average for this procedure, patients should note that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price.
To secure the lowest possible cost, patients are encouraged to verify if the facility offers "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% for upfront payment. Since the cash and negotiated rates are identical in this instance, the primary consideration is ensuring the billing method aligns with your financial situation. If you have insurance, remember that commercial rates often include administrative overhead that can inflate the baseline price, so it is wise to request an itemized bill to confirm no unexpected charges exist. Always check your deductible status before scheduling, as paying out-of-pocket may be necessary if your plan has not yet covered the service.