Blood test, creatinine (kidney)
Facility: Norton County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $15
- Cash Discount Price: $41
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $15 | 293% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Norton County Hospital in Norton, KS, the cash price is $41.00, which is lower than the facility's gross charge of $58.00. While the facility is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average rates for comparison. It is important to note that for patients with high-deductible plans, paying the cash price of $41.00 upfront can sometimes be more cost-effective than using insurance, especially if the insurer's negotiated rate exceeds the cash price. Patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible rate.
Regarding billing protections, patients should be aware that the No Surprises Act generally prevents balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, though unexpected ancillary charges can still occur. If a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, while the Medicare amount for this service is $5.12, commercial rates often include administrative overhead that inflates the baseline price; therefore, comparing the final allowed amount to the Medicare rate provides a clearer picture of the true cost rather than relying on the hospital's gross chargemaster list.