Blood test, creatinine (kidney)
Facility: Great Plains Of Sabetha
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $19
- Cash Discount Price: $20
- vs. Medicare Baseline: 3.71x 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 371% of the Medicare baseline (a markup of 271%). 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 |
|---|---|---|
| Celtic Mcr Adv | $10 | 195% |
| Aetna | $10 - $20 | 195% |
| Celtic Comm Exchange-All Other Plans | $13 | 254% |
| Great West Healthcare-All Plans | $17 | 332% |
| Humana | $19 | 371% |
| Century/Wppa/Providers-All Plans | $19 | 371% |
| Multiplan-Phcs-All Plans | $19 | 371% |
| UnitedHealthcare | $19 - $20 | 371% |
| Federated Mutual Ins-All Plans | $19 | 371% |
| Cigna | $19 | 371% |
| Medicaid / KanCare | $20 | 391% |
| Blue Cross Blue Shield | $20 | 391% |
Consumer Guidance & Cost Commentary
For the CPT code 82565, representing a blood test for creatinine (kidney function), Great Plains Of Sabetha in Sabetha, KS, lists a cash median price of $20.00. This cash rate is notably higher than the state of Kansas average, which is $17.00. While commercial insurance plans such as Aetna, Humana, and UnitedHealthcare negotiate rates ranging from $10 to $20, these negotiated amounts often exceed the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $20.00 directly may result in lower total costs compared to insurance claims where the negotiated rate could be higher. It is advisable to contact the facility directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed.
The facility's Medicare benchmarking data indicates a Medicare amount of $5.12, which serves as the objective baseline for evaluating pricing markups. The reported vs. Medicare variance of 3.7% suggests the facility's rates are significantly higher than the federal cost baseline, highlighting the importance of comparing commercial rates against Medicare rather than the hospital's inflated chargemaster list. Since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill before making any payments to identify potential unbundling or services not rendered. If a balance bill arises from out-of-network ancillary services, patients are protected under the No Surprises Act, which prohibits providers from billing patients for the difference between the chargemaster and the