Blood test, creatinine (kidney)
Facility: Wilson Medical Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $30
- Cash Discount Price: $29
- vs. Medicare Baseline: 5.86x 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 586% of the Medicare baseline (a markup of 486%). 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 | $11 - $38 | 215% |
| Aetna | $20 - $38 | 391% |
| Tricare | $20 | 391% |
| Humana | $20 | 391% |
| Ambetter / Centene | $20 - $38 | 391% |
| UnitedHealthcare | $20 - $35 | 391% |
| Cigna | $30 | 586% |
| Health Partners-All Plans | $35 | 684% |
| Mulitplan-All Plans | $35 | 684% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Wilson Medical Center in Neodesha, KS, the facility's cash median price is $29.00, which is lower than the state average of $38.00. While commercial insurance plans like Blue Cross Blue Shield, Aetna, and Ambetter / Centene have negotiated rates ranging from $20 to $38, these amounts often exceed the cash price. Patients with high-deductible plans may find paying the $29.00 cash median more cost-effective than relying on insurance, as the negotiated rates can be inflated by administrative processing costs and contract dynamics. It is advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available, as paying upfront can sometimes bypass the higher negotiated rates charged to insured members.
This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $5.12 for this procedure. The facility's cash price of $29.00 represents a markup of 5.9 times the Medicare amount, illustrating the typical difference between government-set baselines and commercial pricing. Although the facility is a Critical Access Hospital owned by the local government, commercial rates vary significantly by payer, with Tricare and Humana locking in at $20.00 while UnitedHealthcare and Cigna range between $20.00 and $35.00. To ensure you are receiving the best possible rate, request an itemized bill to verify that no unbundled codes or services not rendered are included, and always compare the final allowed amount against the Medicare benchmark rather than the hospital's full chargemaster list.