Blood test, creatinine (kidney)
Facility: F W Huston Medical Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $29
- Cash Discount Price: $30
- vs. Medicare Baseline: 5.66x 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 566% of the Medicare baseline (a markup of 466%). 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% |
| Aetna | $28 | 547% |
| Humana | $30 | 586% |
| Cigna | $32 | 625% |
Consumer Guidance & Cost Commentary
For this blood test at F W Huston Medical Center in Winchester, KS, the facility's cash and negotiated rates are both $30.00, which is lower than the state average of $38.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that commercial insurance rates often exceed cash prices due to administrative overhead. If you have a high-deductible plan, paying the $30.00 cash price directly might be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if your deductible is not yet met. Additionally, you should inquire about "self-pay" or "prompt-pay" discounts, as hospitals frequently offer fee reductions for upfront payments to bypass costly claims processing.
It is important to understand that the $38.00 gross charge listed represents the facility's full list price, not the amount you will likely pay. Under federal protections like the No Surprises Act, balance billing for out-of-network services at in-network facilities is generally prohibited, though patients should still verify that all ancillary services, such as specific lab components, are covered under the same network agreement. If you receive a bill that exceeds the $30.00 negotiated rate, you have the right to request a formal itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Comparing this rate to the Medicare benchmark of $5.12 reveals a significant markup, highlighting why it is crucial to compare commercial rates against Medicare rather than the inflated chargemaster list when evaluating true value.