Blood test, creatinine (kidney)
Facility: Stanton County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $57
- Cash Discount Price: $43
- vs. Medicare Baseline: 11.13x 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 1113% of the Medicare baseline (a markup of 1013%). 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 - $230 | 195% |
| Healthy Blue Mcr Adv - All Other Plans | $57 - $238 | 1113% |
| Healthy Blue Mcaid | $58 - $207 | 1133% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Stanton County Hospital in Johnson, KS, the cash price is $43.00, which matches the facility's median negotiated rate. This cash price is significantly lower than the Medicare benchmark of $5.12, indicating a substantial markup on the commercial rate. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the $43.00 cash price more affordable than using insurance, as the negotiated rates for in-network plans range from $57.00 to $238.00. We recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
To ensure you are not overcharged, it is crucial to request a full itemized bill rather than accepting a summary invoice that obscures individual line items. Since over 80% of hospital bills contain errors, such as unbundled codes or services not rendered, verifying the exact CPT codes and unit costs is the most effective way to reduce medical debt. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should still verify your deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash upfront.