Blood test, creatinine (kidney)
Facility: Kiowa County Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $45
- Cash Discount Price: $43
- vs. Medicare Baseline: 8.79x 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 879% of the Medicare baseline (a markup of 779%). 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 - $44 | 215% |
| UnitedHealthcare | $40 - $50 | 781% |
| Humana | $44 | 859% |
| Celtic Comml Exchange-All Other Plans | $44 | 859% |
| Aetna | $44 | 859% |
| Medica Prime Mcare Cost-All Plans | $44 | 859% |
| Health Partners Of Ks-All Plans | $44 | 859% |
| Medicaid / KanCare | $50 | 977% |
| Providrs Care/Wppa-All Plans | $75 | 1465% |
Consumer Guidance & Cost Commentary
For the blood test, creatinine (kidney) procedure at Kiowa County Memorial Hospital, the facility's cash median price is $43.00, which is lower than the negotiated rates paid by most major payers. While the hospital's cash price is $43.00, the median negotiated rate across all payers is $45.00, meaning patients with high-deductible plans might save money by paying cash directly rather than using insurance, as the insurer's allowed amount often exceeds the cash price. The facility is a Critical Access Hospital in Greensburg, KS, and its cash rate is notably lower than the state average of $45.00, though it remains slightly below the national average of $46.00 for this service.
Patients should be aware that while the hospital offers a cash rate of $43.00, insurance contracts often result in higher out-of-pocket costs due to administrative fees and negotiated markups. For instance, Medicaid/KanCare pays $50.00, and UnitedHealthcare pays up to $50.00, which are higher than the cash price. To minimize costs, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the bill by 20% to 50%. Additionally, if a patient receives care from an out-of-network provider at this facility, they may be subject to balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects against such billing for emergency services and non-emergency services from out-of-network providers at in-network facilities.