Blood test, creatinine (kidney)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $18
- Cash Discount Price: $19
- vs. Medicare Baseline: 3.52x 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 352% of the Medicare baseline (a markup of 252%). 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 |
|---|---|---|
| Tricare | $15 | 293% |
| Humana | $17 | 332% |
| Hpk-All Plans | $18 | 352% |
| Aetna | $18 - $19 | 352% |
| UnitedHealthcare | $18 | 352% |
| Medicaid / KanCare | $19 | 371% |
Consumer Guidance & Cost Commentary
For the blood test, creatinine (kidney) procedure at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash median price is $19.00, which matches the facility's gross charge. This cash rate is significantly lower than the state average, as indicated by a 3.5% variance compared to Medicare benchmarks. While the facility is a Critical Access Hospital owned by the Government - Hospital District or Authority, patients with high-deductible plans may find paying the cash price upfront more cost-effective than using insurance, as the negotiated rates for payers like Aetna and UnitedHealthcare range from $18.00 to $19.00. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
Although the facility offers in-network options for Tricare, Humana, Hpk-All Plans, Medicaid / KanCare, and UnitedHealthcare, the negotiated amounts remain consistent with the cash price, hovering around $18.00 to $19.00. This suggests that for this specific service, the administrative overhead associated with insurance billing does not result in a higher final cost for the patient compared to paying directly. However, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services are out-of-network. If a patient receives a bill exceeding these negotiated amounts, they should request a formal itemized billing audit to identify any errors, unbundled