Blood test, creatinine (kidney)
Facility: Morris County Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $28
- Cash Discount Price: $44
- vs. Medicare Baseline: 5.47x 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 547% of the Medicare baseline (a markup of 447%). 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 |
|---|---|---|
| Va Ccn-All Plans | $4 | 78% |
| Providrs Care (Wppa)(Nexus)-All Plans | $5 | 98% |
| Aetna | $6 | 117% |
| Blue Cross Blue Shield | $10 - $28 | 195% |
| Coventry Mcr | $28 | 547% |
| Choice Care Mcr Adv-All Plans | $28 | 547% |
| UnitedHealthcare | $28 - $73 | 547% |
| Cigna | $53 | 1035% |
| Coventry Comm-All Other Plans | $66 | 1289% |
| Multiplan-All Plans | $66 | 1289% |
Consumer Guidance & Cost Commentary
For this blood test for creatinine at Morris County Hospital in Council Grove, Kansas, the facility's cash median price is $44.00, which is lower than the state average of $53.00. While the hospital's negotiated rates with major insurers like UnitedHealthcare and Blue Cross Blue Shield range from $28.00 to $73.00, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the $44.00 cash rate more cost-effective than relying on insurance, as the negotiated allowed amounts can sometimes exceed the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might result in immediate savings if your insurance has not yet covered the service.
The facility is a Critical Access Hospital with a government-local ownership structure, and its pricing reflects a transparent approach where cash payments can bypass complex billing cycles. Although the Medicare benchmark for this service is $5.12, commercial rates are significantly higher due to the inclusion of work, practice expenses, and malpractice insurance. If you receive a bill that includes charges for services not rendered or unbundled components, you should request a full itemized audit to identify errors before making a payment. Additionally, if you are concerned about balance billing from out-of-network ancillary services, remember that the No Surprises Act protects you from being billed the difference between the provider's chargemaster and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Always ask the billing department about prompt-pay discounts before check-in to ensure you are receiving the lowest possible rate for your situation.