Blood test, creatinine (kidney)
Facility: Sheridan County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $15
- Cash Discount Price: $22
- vs. Medicare Baseline: 2.93x 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 293% of the Medicare baseline (a markup of 193%). 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 Insurance | $13 | 254% |
| Blue Cross Blue Shield | $15 | 293% |
| UnitedHealthcare | $21 | 410% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Sheridan County Hospital in Hoxie, Kansas, the cash price is $22.00, which matches the facility's median negotiated rate of $15.00 and the state average. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial insurance rates for this service are significantly higher; for instance, UnitedHealthcare's negotiated rate is $21.00 and Blue Cross Blue Shield's is $15.00. Because the cash price of $22.00 is lower than the negotiated rates charged by major payers like UnitedHealthcare, patients with high-deductible plans or those without insurance may save money by paying the cash price directly. It is important to verify if the facility offers a "self-pay" or "prompt-pay" discount, as paying upfront can sometimes reduce the final amount owed before insurance billing cycles begin.
When reviewing your bill, be aware that the Medicare amount for this procedure is $5.12, and the facility's cash rate is 2.9 times higher than the Medicare benchmark. This markup is common in commercial billing, where negotiated rates often exceed Medicare amounts due to administrative costs and contract structures. If you receive a bill from an out-of-network provider or a service that was not fully covered by your insurance, you may face balance billing, where the provider charges the difference between their full rate and what your insurer paid. However, federal protections under the No Surprises Act generally ban balance billing for emergency care and non-emergency services at in-network facilities. If you do receive an unexpected bill, do not pay immediately; instead, request an itemized audit to identify errors