Blood test, creatinine (kidney)
Facility: Fredonia Regional Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $33
- Cash Discount Price: $36
- vs. Medicare Baseline: 6.45x 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 645% of the Medicare baseline (a markup of 545%). 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 | $2 - $33 | 39% |
| Blue Cross Blue Shield | $11 - $18 | 215% |
| Aetna | $19 - $33 | 371% |
| Veterans Programs - All Plans | $19 | 371% |
| Cigna | $33 | 645% |
| Meritain-All Plans | $33 | 645% |
| Reserve National-All Plans | $33 | 645% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine (kidney) at Fredonia Regional Hospital, the cash price is $36.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $5.12, reflecting a markup common in commercial billing where negotiated rates often average 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital in Kansas with government-local ownership, patients should note that the negotiated rates for major payers like UnitedHealthcare and Aetna range from $11 to $33, which is generally higher than the cash price. This dynamic suggests that for patients with high-deductible plans, paying the cash price directly might be more cost-effective than relying on insurance, as the administrative overhead and contract structures can inflate the allowed amount above the cash rate.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the costly insurance claims cycle. It is also important to verify your specific plan's deductible status before scheduling, as paying the negotiated rate without meeting your deductible can result in unexpected out-of-pocket expenses. Finally, if you receive a bill, request a full itemized statement to review every line item for errors or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute rather than accepting a summary invoice.