Blood test, creatinine (kidney)
Facility: Logan County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $86
- Cash Discount Price: $25
- vs. Medicare Baseline: 16.80x 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 1680% of the Medicare baseline (a markup of 1580%). 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% |
| Humana | $53 | 1035% |
| Health Partners - All Plans | $119 | 2324% |
| Medicaid / KanCare | $125 | 2441% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Logan County Hospital in Oakley, Kansas, the facility's cash price of $25.00 is significantly lower than the negotiated rates paid by major insurers, which range from $11 to $125 depending on the plan. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while Medicaid/KanCare pays the full gross charge of $125.00, commercial payers like Blue Cross Blue Shield and Humana pay substantially less, illustrating how insurance contracts can result in higher out-of-pocket costs for members compared to self-pay options.
When evaluating the value of this service, it is essential to compare rates against federal benchmarks rather than the hospital's full list price. The Medicare amount for this procedure is $5.12, meaning the cash price of $25.00 is approximately 488% of the Medicare rate, which is higher than the typical fair pricing range of 120% to 150% of Medicare. To minimize costs, patients should request a prompt-pay discount before scheduling, which can reduce the balance further, and must insist on an itemized billing audit if they receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Finally, if a patient encounters a balance bill from an out-of-network provider at this in-network facility, they should not pay immediately but instead dispute the charge with their insurer to ensure compliance with the