Blood test, creatinine (kidney)
Facility: Kiowa District Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $37
- Cash Discount Price: $31
- vs. Medicare Baseline: 7.23x 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 723% of the Medicare baseline (a markup of 623%). 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 |
|---|---|---|
| Healthchoice-All Plans | $8 | 156% |
| Blue Cross Blue Shield | $11 | 215% |
| Tricare | $15 | 293% |
| UnitedHealthcare | $31 - $39 | 605% |
| Health Partners Of Ks-All Plans | $34 | 664% |
| Humana | $35 | 684% |
| Multiplan-All Plans | $37 | 723% |
| Medicare (plans) | $37 | 723% |
| Triwest-All Plans | $37 | 723% |
| Aetna | $37 | 723% |
| Gbs Insurance - All Plans | $37 | 723% |
| Medicaid / KanCare | $39 | 762% |
| Providers Care (Wppa)-All Plans | $58 | 1133% |
| Liberty Healthshare-All Plans | $63 | 1230% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Kiowa District Hospital, the negotiated rates range from $8 to $63 depending on your specific insurance plan, with a median negotiated amount of $37. This facility is a Critical Access Hospital in Kiowa, Kansas, and its pricing is notably higher than the state average. While the cash price is $31, which is lower than the median negotiated rate of $37, patients with high-deductible plans may find it beneficial to pay the cash price directly, as the insurance negotiated rate often exceeds the cash price due to administrative costs and contract dynamics. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly even within the same facility.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the costly insurance claims process. Additionally, since the Medicare benchmark for this service is $5.12, the commercial negotiated rates reflect a significant markup; fair pricing is typically defined as 120% to 150% of the Medicare rate, whereas commercial rates often average 200% to 300% higher. Consumers should avoid accepting summary bills and instead request a detailed, itemized statement to identify any errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.