Blood test, creatinine (kidney)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $18
- Cash Discount Price: $20
- vs. Medicare Baseline: 3.52x 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 352% of the Medicare baseline (a markup of 252%). 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 |
|---|---|---|
| Va Ccn - All Plans | $2 | 39% |
| Humana | $9 - $15 | 176% |
| Tricare | $10 - $16 | 195% |
| Medicaid / KanCare | $11 - $30 | 215% |
| UnitedHealthcare | $11 - $30 | 215% |
| Aetna | $11 - $27 | 215% |
| Ambetter / Centene | $12 - $20 | 234% |
| Blue Cross Blue Shield | $15 | 293% |
| Health Partners - All Plans | $17 - $28 | 332% |
| Healthy Blue Mcaid - All Plans | $18 - $30 | 352% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Trego County Lemke Memorial Hospital in Wakeeney, KS, the facility's cash price of $20.00 is slightly higher than the state average of $19.00 and the county average of $18.00. While the hospital is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price directly more affordable than using insurance, as commercial negotiated rates often exceed cash prices due to administrative overhead. The facility's median negotiated rate across ten payers is $18.00, which is lower than the cash price, but this rate is subject to your specific plan's deductible status; if your deductible has not been met, you may still owe the full negotiated amount before insurance covers any portion of the cost.
When comparing this service to federal benchmarks, the Medicare amount of $5.12 serves as the objective baseline for pricing, revealing that the facility's cash price represents a significant markup over the government rate. This discrepancy highlights why comparing rates to the Medicare amount is more accurate than looking at the hospital's full chargemaster list, which can be inflated to make discounts appear larger than they are. To ensure you are receiving the best possible rate, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full upfront. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, you can rest assured that you will not be billed for the difference between the provider's full charge and your insurance