Blood test, creatinine (kidney)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $32
- Cash Discount Price: $28
- vs. Medicare Baseline: 6.25x 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 625% of the Medicare baseline (a markup of 525%). 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 | $32 - $35 | 625% |
| Providers Care (Wppa)-All Plans | $61 | 1191% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price is $28.00, which is lower than the negotiated rates of $32.00 paid by UnitedHealthcare and Providers Care (Wppa). While the facility is a Critical Access Hospital owned by the government, patients with high-deductible plans may find paying cash directly more affordable than using insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility is in-network for three payers, the No Surprises Act protects patients from balance billing for out-of-network services at this location, though patients should still verify their specific plan details before scheduling to ensure they are not subject to unexpected ancillary charges.
When evaluating the cost against federal standards, the Medicare benchmark for this service is $5.12, and the facility's cash rate of $28.00 represents a markup of 6.2 times the Medicare amount. Although commercial negotiated rates are typically higher than cash prices due to administrative overhead and contract structures, the cash median here is still significantly above the Medicare baseline. Consumers are encouraged to request a prompt-pay discount or self-pay rate before check-in, as paying upfront can sometimes reduce the final bill further. Additionally, patients should always demand a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be identified and corrected through a formal audit dispute.