Blood test, creatinine (kidney)
Facility: Stevens County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $25
- Cash Discount Price: $65
- vs. Medicare Baseline: 4.88x 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 488% of the Medicare baseline (a markup of 388%). 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 |
|---|---|---|
| Aetna | $3 - $65 | 59% |
| Blue Cross Blue Shield | $10 - $11 | 195% |
| Humana | $24 | 469% |
| First Health - All Plans | $58 | 1133% |
| Wppa - All Plans | $62 | 1211% |
| Medicaid / KanCare | $65 | 1270% |
Consumer Guidance & Cost Commentary
For this blood test service at Stevens County Hospital in Hugoton, Kansas, the cash price is $65.00, which matches the facility's gross chargemaster rate. While the median negotiated rate across six payers is $25.00 and the median amount paid by insurers is $42.00, the cash price remains the highest figure listed. This scenario highlights a common billing dynamic where cash payments can sometimes be more affordable than insurance claims, particularly for patients with high-deductible plans or those who have already met their out-of-pocket maximum. Because the cash price is identical to the gross charge, there is no immediate discount available for paying upfront, but patients should still inquire about "self-pay" or "prompt-pay" discounts directly with the hospital, as these rates are not always reflected in the standard price transparency data.
When evaluating the value of this service, it is important to compare the facility's pricing against objective benchmarks rather than the inflated chargemaster list. The Medicare benchmark for this code is $5.12, which serves as the scientifically validated baseline for the true cost of care. The facility's cash rate of $65.00 represents a significant markup over the Medicare rate, while the median negotiated rate of $25.00 suggests that commercial contracts are also substantially higher than the federal baseline. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized statement before paying to ensure no unbundled codes or services not rendered are included. Additionally, if a patient receives care from an out-of-network provider or encounters unexpected ancillary charges, they may be subject to balance billing; however, the No Surprises Act protects