Blood test, creatinine (kidney)
Facility: Osborne County Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $48
- Cash Discount Price: $45
- vs. Medicare Baseline: 9.38x 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 938% of the Medicare baseline (a markup of 838%). 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 |
|---|---|---|
| UnitedHealthcare | $40 | 781% |
| Health Partners Of Kansas | $46 | 898% |
| Wppa | $50 | 977% |
| Blue Cross Blue Shield | $52 | 1016% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Osborne County Memorial Hospital, the cash price of $45.00 is lower than the facility's negotiated rates with major payers like UnitedHealthcare ($40.00) and Health Partners Of Kansas ($46.00). This suggests that patients with high-deductible plans or those without insurance might save money by paying cash directly, as the cash rate is already below the amounts commercial insurers typically negotiate. However, it is important to note that the facility's cash rate is still higher than the Medicare benchmark of $5.12, indicating a significant markup relative to the federal government's cost-based reimbursement. Additionally, the cash price is notably higher than the median negotiated rate of $48.00 reported for this service in the broader region, highlighting that while cash may be cheaper than insurance payments here, it does not represent the lowest possible price available for this procedure.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services like specific lab components are billed separately. To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. Furthermore, since the facility offers a cash price of $45.00, you should explicitly ask at registration for a "self-pay" or "prompt-pay" discount, which could further reduce the cost by bypassing administrative fees associated with insurance claims. Given that the facility is a Critical Access Hospital in Osborne, KS, and is government-owned, verifying your specific plan's allowed amount is crucial to avoid any potential balance billing surprises