Blood test, creatinine (kidney)
Facility: Hodgeman County Health Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $50
- Cash Discount Price: $57
- vs. Medicare Baseline: 9.77x 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 977% of the Medicare baseline (a markup of 877%). 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 | $10 - $11 | 195% |
| Humana | $45 | 879% |
| UnitedHealthcare | $45 - $67 | 879% |
| Medicaid / KanCare | $45 - $71 | 879% |
| Triwest - All Plans | $45 | 879% |
| Aetna | $57 | 1113% |
| First Health - All Plans | $64 | 1250% |
| Wppa (Provdrscare) - All Plans | $67 | 1309% |
| Health Partners - All Plans | $67 | 1309% |
Consumer Guidance & Cost Commentary
For the CPT code 82565, representing a blood test for creatinine (kidney function), Hodgeman County Health Center in Jetmore, KS, lists a gross charge of $71.00. The facility's cash median price is $57.00, which is lower than the negotiated rates paid by most insurance payers, ranging from $45.00 to $71.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price of $57.00 more cost-effective than relying on insurance, as many commercial negotiated rates exceed the cash amount. To minimize costs, patients should verify if their specific plan allows for self-pay or prompt-pay discounts, which can further reduce the final bill.
The Medicare benchmark for this service is $5.12, highlighting a significant markup on the federal baseline. The facility's cash rate of $57.00 is approximately 11 times the Medicare amount, while the median negotiated rate of $50.00 remains substantially higher than the Medicare benchmark. Although the data does not provide specific county or state average comparisons for this exact procedure, the disparity between the Medicare rate and the facility's cash price underscores the importance of understanding the difference between the government's cost baseline and commercial pricing. Consumers are advised to request an itemized bill to ensure no unbundled charges or errors exist, as these can inflate the total cost beyond the listed rates.