Blood test, creatinine (kidney)
Facility: Hamilton County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $45
- Cash Discount Price: $50
- vs. Medicare Baseline: 8.79x 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 879% of the Medicare baseline (a markup of 779%). 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 | $5 - $11 | 98% |
| First Health Coventry - All Plans | $42 | 820% |
| Cigna | $47 | 918% |
| UnitedHealthcare | $47 | 918% |
| Va Ccn - All Plans | $50 | 977% |
| Aetna | $85 | 1660% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Hamilton County Hospital in Syracuse, KS, the cash price is $50.00, which matches the facility's negotiated rate of $45.00 and the median paid amount of $47.00. This cash 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 plans like Blue Cross Blue Shield and First Health Coventry have negotiated rates ranging from $5 to $47, these amounts are still well above the Medicare baseline. Because the cash price is already competitive with the facility's negotiated rates, patients with high-deductible plans may find paying out-of-pocket is the most cost-effective option, provided they confirm the facility's self-pay or prompt-pay discounts before scheduling.
Patients should be aware that hospitals often issue summary bills that obscure individual charges, making it difficult to identify errors or unbundled codes. To protect against overcharging, consumers should request a full itemized CPT-coded bill before paying, ensuring no services were billed that were not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify your deductible status before using insurance, as paying the negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash. Given that the facility is a Critical Access Hospital with government ownership, comparing the $50.00 cash price directly to the state average highlights that this specific service is priced above the typical cost for this procedure in Kansas.