Blood test, creatinine (kidney)
Facility: Stafford County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $34
- Cash Discount Price: $35
- vs. Medicare Baseline: 6.64x 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 664% of the Medicare baseline (a markup of 564%). 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 | $2 | 39% |
| Va Ccn-All Plans | $2 | 39% |
| Health Partners-All Plans | $34 | 664% |
| Humana | $35 | 684% |
| Medica Mcr- All Plans | $35 | 684% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Stafford County Hospital, the cash price is $35.00, which matches the facility's negotiated rate and the median paid amount. This service is significantly more expensive than the Medicare benchmark of $5.12, reflecting a markup of 6.6 times the federal rate. While the facility is a Critical Access Hospital in Stafford, Kansas, and is owned by the local government, the data does not provide specific average rates for the county or state to compare against. Patients should note that cash-paying can sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price, though in this specific case, the cash and negotiated rates are identical.
To minimize potential costs, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these programs often offer immediate fee reductions for upfront payment. Additionally, because over 80% of hospital bills contain errors, it is advisable to request a full itemized CPT-coded statement rather than accepting a summary bill, which may obscure unbundled charges or services not rendered. If a patient receives a bill that includes charges for out-of-network services at an in-network facility, they may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and certain non-emergency services.