CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Scott County Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $58
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 11.33x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Scott County Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 11.33x the Medicare baseline. Located in 201 Albert Avenue, Scott City, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5.12

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.12 (100%)
Insurance Median: $58 (1133%)
Ins. Median: $58 (1133% of 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 1133% of the Medicare baseline (a markup of 1033%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $5 - $61 98%
Blue Cross Blue Shield $11 215%
Humana $27 527%
Wppa $38 - $1,200 742%
Aetna $58 1133%

Consumer Guidance & Cost Commentary

For the blood test for creatinine at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $5 to $1200 depending on the insurance plan, with a median negotiated rate of $58.00. This facility is a Critical Access Hospital owned by a voluntary non-profit private entity, and its pricing is benchmarked against Medicare, which sets the standard reimbursement at $5.12. While the facility's negotiated rates are significantly higher than the Medicare amount, commercial insurance plans like UnitedHealthcare, Blue Cross Blue Shield, Humana, Aetna, and WPPA offer specific payment ranges that vary by plan. Patients should be aware that while these negotiated rates protect in-network members from the full chargemaster price, they often exceed the actual cost of care due to administrative overhead and contract dynamics.

For patients with high-deductible plans, paying cash directly may result in lower out-of-pocket costs compared to using insurance, as the insurance negotiated rate can sometimes exceed the cash price. The facility does not list a specific cash median, but patients are encouraged to ask directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. It is crucial to request these discounts before scheduling services and to sign a waiver preventing automatic claims submission to ensure the cash rate applies. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected to reduce medical debt.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Albert Avenue, Scott City, KS 67871
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals