Blood test, creatinine (kidney)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $15
- Cash Discount Price: $27
- 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 | $11 | 215% |
| Aetna | $12 - $24 | 234% |
| UnitedHealthcare | $15 - $18 | 293% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Community Memorial Healthcare in Marysville, KS, the cash price of $27.00 is identical to the facility's median negotiated rate of $24.00 and the Medicare benchmark of $5.12. While the facility's negotiated rate is lower than the gross charge, it is important to note that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price matches the negotiated amount, meaning patients with high-deductible plans who have not yet met their out-of-pocket maximum may find paying out-of-pocket directly is the most cost-effective option. However, patients should always verify their specific plan's allowed amount before scheduling, as some insurers may negotiate different rates that could result in higher out-of-pocket costs if the patient's deductible has not been satisfied.
The facility's pricing for this service is significantly higher than the Medicare benchmark, which serves as the objective baseline for evaluating hospital markups. While the data does not provide specific county or state average comparisons for this exact CPT code, the facility's cash rate of $27.00 is roughly 5.3 times the Medicare amount. To ensure you are receiving the best possible price, we recommend requesting a formal itemized billing audit before payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, effectively bypassing the administrative costs associated with insurance claims processing.