Blood test, creatinine (kidney)
Facility: Ellsworth County Medical Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $28
- Cash Discount Price: $31
- vs. Medicare Baseline: 5.47x 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 547% of the Medicare baseline (a markup of 447%). 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 | $10 - $11 | 195% |
| Humana | $15 - $29 | 293% |
| Triwest -All Plans | $15 | 293% |
| Healthy Blue Mcr Adv | $15 | 293% |
| Va Ccn-All Plans | $15 | 293% |
| UnitedHealthcare | $20 - $31 | 391% |
| Aetna | $28 | 547% |
| First Health - All Plans | $28 | 547% |
| Cigna | $29 | 566% |
| Medicaid / KanCare | $31 | 605% |
| Healthy Blue Mcaid- All Other Plans | $31 | 605% |
| Coventry Mcaid-All Plans | $31 | 605% |
| Providers Care-Wppa-All Plans | $46 | 898% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Ellsworth County Medical Center, the cash price is $31.00, which matches the facility's negotiated rate with Medicaid and several other payers. While the median amount paid by insurance for this service is $22.00, patients should be aware that cash-paying can sometimes be more cost-effective if their insurance plan has a high deductible or if the negotiated rate exceeds the cash price. The facility offers a prompt-pay discount for upfront payment, which can further reduce the final bill.
When evaluating costs, it is important to compare rates against objective benchmarks rather than the hospital's full list price. The Medicare amount for this procedure is $5.12, and the facility's cash rate of $31.00 represents a significant markup above this federal baseline. Additionally, the facility's rating of 2 and its status as a Critical Access Hospital in Ellsworth, KS (ZIP 67439) are relevant factors in understanding local pricing structures. Consumers are encouraged to request an itemized bill to verify all charges and to explicitly ask about self-pay or prompt-pay discounts before scheduling any services to avoid unexpected balance billing.