Blood test, creatinine (kidney)
Facility: Phillips County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $32
- Cash Discount Price: $30
- 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 | $11 - $28 | 215% |
| UnitedHealthcare | $28 - $35 | 547% |
| Health Partners-All Plans | $35 | 684% |
| Medicaid / KanCare | $35 | 684% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Phillips County Hospital in Phillipsburg, KS, the cash price of $30.00 is lower than the facility's negotiated rates with major insurers like Blue Cross Blue Shield and UnitedHealthcare, which range from $28.00 to $35.00. While the facility is a Critical Access Hospital with government local ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated amounts often exceed the cash rate. To secure the lowest possible cost, it is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling the service.
When evaluating the cost against federal standards, the facility's cash rate of $30.00 is 6.2% higher than the Medicare benchmark of $5.12, reflecting the specific cost structure of this Critical Access Hospital in Kansas. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no unbundled charges or services not rendered are included. If a discrepancy arises, disputing the bill in writing with the billing supervisor is the most effective way to identify errors and reduce potential medical debt.