Blood test, creatinine (kidney)
Facility: Lincoln County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $11
- Cash Discount Price: $44
- vs. Medicare Baseline: 2.15x 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 215% of the Medicare baseline (a markup of 115%). 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 | 215% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Lincoln County Hospital in Lincoln, KS, the cash price is $44.00, which is significantly lower than the facility's gross charge of $49.00. While the facility is a Critical Access Hospital owned by the local government, the negotiated rate for in-network payers like Blue Cross Blue Shield is $11.00. This negotiated amount is notably lower than the cash price, meaning patients with high-deductible plans or those without insurance may find it more cost-effective to pay the cash rate of $44.00 directly, provided they can secure the discount. It is important to verify with the hospital's billing department whether a "self-pay" or "prompt-pay" discount is available, as paying upfront can sometimes bypass administrative fees and reduce the final amount owed.
When evaluating the cost of this service, it is essential to compare rates against the Medicare benchmark rather than the hospital's full list price. The Medicare reimbursement amount for this procedure is $5.12, and the facility's negotiated rate of $11.00 represents a markup of approximately 214% over the Medicare rate. While commercial negotiated rates often average between 200% and 300% of Medicare, fair pricing is typically defined as 120% to 150% of the Medicare amount. Consumers should be aware that hospitals may issue summary bills that obscure individual charges, so requesting a detailed, itemized statement is a critical step to identify any unbundled codes or services not rendered. Always dispute any errors in writing to ensure accurate billing and avoid unexpected costs.