Blood test, creatinine (kidney)
Facility: Mitchell County Hospital Health Systems
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $46
- Cash Discount Price: $43
- vs. Medicare Baseline: 8.98x 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 898% of the Medicare baseline (a markup of 798%). 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 | $5 - $48 | 98% |
| Blue Cross Blue Shield | $11 | 215% |
| Triwest Well Mark All Plans | $41 | 801% |
| First Health-All Plans | $43 | 840% |
| Pref Hlth Care Sytms Comm - All Plans | $43 | 840% |
| Aetna | $43 | 840% |
| Multiplan Ppo - All Plans | $46 | 898% |
| Auxiant-All Plans | $46 | 898% |
| Phc Leased Ntwrk Access - All Plans | $46 | 898% |
| Health Partners Ks-All Plans | $48 | 938% |
| Cigna | $48 | 938% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Mitchell County Hospital Health Systems in Beloit, Kansas, the facility's cash price of $43.00 is lower than the state average of $48.00, making it a cost-effective option for self-pay patients. While the facility's negotiated rates with insurance plans range from $11 to $48, the cash price often provides a better deal for those with high-deductible plans or those without coverage, as the cash rate is below the gross charge and comparable to many negotiated amounts. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes reduce the final amount further than the listed cash price.
It is important to understand that commercial insurance rates are often higher than cash prices due to administrative costs and contract structures, meaning a patient might pay less by paying out-of-pocket. Additionally, if a patient receives care from an out-of-network provider at this facility, they could face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects against this for emergency and non-emergency services at in-network facilities. To avoid unexpected costs, patients should request a detailed, itemized bill rather than accepting a summary invoice, as hospitals frequently overcharge by unbundling services or billing for items not rendered. Disputing any errors in writing via certified mail is the most effective way to ensure the final bill reflects the true cost of care.