Blood test, creatinine (kidney)
Facility: Hiawatha Community Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $44
- Cash Discount Price: $57
- vs. Medicare Baseline: 8.59x 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 859% of the Medicare baseline (a markup of 759%). 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 | $10 - $11 | 195% |
| UnitedHealthcare | $21 - $49 | 410% |
| Humana | $21 | 410% |
| Aetna | $21 - $46 | 410% |
| Ambetter / Centene | $25 | 488% |
| Centrus Health Direct - All Plans | $43 | 840% |
| Oscar - All Plans | $43 | 840% |
| Preferred Hlth - All Plans | $51 | 996% |
| Cigna | $54 | 1055% |
| Wppa Providrs Care - All Plans | $54 | 1055% |
| Multiplan - All Plans | $55 | 1074% |
| Midlands Choice - All Plans | $55 | 1074% |
| Healthy Blue Mcaid - All Plans | $57 | 1113% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $57.00, which matches the facility's negotiated rate for in-network payers. This cash price is significantly higher than the state average for this service, which is $46.00. Because the cash price exceeds the state average, patients with high-deductible plans may find it financially beneficial to pay the full cash price of $57.00 upfront rather than relying on insurance, as the negotiated rates paid by insurers often exceed the cash price due to administrative overhead. To potentially lower this cost, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full before or shortly after the service.
The facility's negotiated rates for this procedure range from $10 to $57 across 13 different insurance plans, with the lowest allowed amount being $10 and the highest being $57. While the facility is a Critical Access Hospital owned by a voluntary non-profit, the cash price remains above the state median paid amount of $46.00. When reviewing the bill, patients should request an itemized statement to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can dispute any unexpected charges without fear of credit damage. For the most accurate pricing, patients should verify their specific plan's deductible status and allowed amounts before scheduling the test.