Blood test, creatinine (kidney)
Facility: Minneola District Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $18
- Cash Discount Price: $14
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $11 | 215% |
| Humana | $13 | 254% |
| UnitedHealthcare | $13 - $20 | 254% |
| Va Community Care Program-All Plans | $13 | 254% |
| Providrs Care Network-All Plans | $17 | 332% |
| Corporate Plan Management-All Plans | $17 | 332% |
| Triwest-All Plans | $18 | 352% |
| Preferred Health Care (Coventry)-All Other Plans | $18 | 352% |
| Phc (Coventry) Leased Network | $19 | 371% |
| Aetna | $19 - $20 | 371% |
| Health Partners Of Kansas-All Plans | $19 | 371% |
| Medicaid / KanCare | $20 | 391% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Minneola District Hospital, the facility's cash median price of $14.00 is lower than the state average for this service. While the facility's negotiated rates range from $11 to $20 depending on the insurance plan, these amounts are generally higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash median of $14.00 upfront more cost-effective than using insurance, which could result in a higher allowed amount that exceeds the cash rate. It is important to verify the specific negotiated rate for your plan before scheduling, as in-network rates vary significantly across different carriers and can sometimes be higher than the self-pay price.
The facility's Medicare benchmark amount of $5.12 serves as the baseline for evaluating pricing, with the cash price representing a markup of 3.5 times the Medicare rate. Although the facility is a government-owned Critical Access Hospital in Kansas, commercial negotiated rates often include additional layers of administrative overhead that are not reflected in the Medicare calculation. To ensure you receive the best possible price, we recommend requesting a prompt-pay discount if you choose to pay directly, which can reduce the bill by 20% to 50% by bypassing insurance billing cycles. Additionally, always ask for an itemized bill to review the specific CPT code for the blood test and confirm that no unexpected charges or balance billing have been applied before finalizing payment.