Blood test, creatinine (kidney)
Facility: Cloud County Health Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $52
- Cash Discount Price: $38
- vs. Medicare Baseline: 10.16x 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 1016% of the Medicare baseline (a markup of 916%). 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 |
|---|---|---|
| Aetna | $49 - $51 | 957% |
| Mpi-All Plans | $52 | 1016% |
| Health Partners - All Plans | $52 | 1016% |
| Pponext-All Plans | $52 | 1016% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Cloud County Health Center in Concordia, KS, the facility's cash median price is $38.00, which is lower than the state average of $55.00. While the facility's negotiated rate with most payers is $52.00, this amount is significantly higher than the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket if their insurance allowed amount exceeds $38.00. It is important to note that the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially lower the final cost.
When comparing this service to Medicare, the facility's cash rate of $38.00 is 10.2% higher than the Medicare benchmark of $5.12, which serves as the objective baseline for evaluating hospital pricing markups. Although the facility's gross charge is $55.00, commercial insurance contracts typically cap payments at negotiated rates rather than the full list price, which can sometimes result in higher out-of-pocket costs for patients who have not yet met their deductibles. To ensure you are receiving fair pricing, we recommend requesting an itemized billing audit to confirm that no unbundled codes or services not rendered are included in the final statement, as over 80% of hospital bills contain errors that can be corrected.