Blood test, creatinine (kidney)
Facility: Graham County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $17
- Cash Discount Price: $30
- vs. Medicare Baseline: 3.32x 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 332% of the Medicare baseline (a markup of 232%). 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 - $28 | 39% |
| Medicaid / KanCare | $8 | 156% |
| Blue Cross Blue Shield | $11 | 215% |
| Medicare (plans) | $22 | 430% |
| Celtic Commercial-All Other Plans | $25 | 488% |
| Wppa (Providers Care)-All Plans | $28 | 547% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Graham County Hospital in Hill City, KS, the cash price is $30.00, which matches the facility's median negotiated rate of $17.00 and the cash median of $30.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead. In this case, the negotiated rate of $17.00 is lower than the cash price, but patients with high-deductible plans might find paying the full cash price of $30.00 upfront more cost-effective if their insurance deductible has not yet been met, as some commercial contracts can result in higher out-of-pocket costs than direct payment.
When evaluating the cost relative to Medicare, the facility's cash rate of $30.00 is 3.3 times the Medicare benchmark of $5.12, which is significantly higher than the typical fair pricing range of 120% to 150% of Medicare. This markup is common in commercial billing, where rates can average 200% to 300% of Medicare, but it is important to compare against the Medicare rate rather than the hospital's gross chargemaster to understand the true cost. To minimize expenses, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims processing.