Blood test, creatinine (kidney)
Facility: Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $30
- Cash Discount Price: $55
- vs. Medicare Baseline: 5.86x 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 586% of the Medicare baseline (a markup of 486%). 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 | $8 | 156% |
| Tricare | $27 | 527% |
| Humana | $27 | 527% |
| Medicare (plans) | $28 | 547% |
| Ambetter / Centene | $30 | 586% |
| Coventry - All Other Plans | $49 | 957% |
| Health Partners Of Kansas - All Plans | $52 | 1016% |
| Preferred Healthcare-All Plans | $52 | 1016% |
| Wppa/Providers Care-All Plans | $76 | 1484% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Memorial Hospital in Abilene, Kansas, the cash price is $55.00, which matches the facility's median negotiated rate of $30.00 and the median paid amount of $28.00. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should be aware that commercial insurance plans like Blue Cross Blue Shield, Tricare, and Humana negotiate rates ranging from $8 to $76 depending on the specific plan. Because the cash price is identical to the facility's median negotiated rate, patients with high-deductible plans may find paying out-of-pocket is more cost-effective than using insurance, which could result in higher allowed amounts due to administrative overhead. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can further reduce the final bill.
This service is priced significantly higher than the Medicare benchmark of $5.12, with the cash rate representing a 5.9x markup compared to the federal government's fixed reimbursement rate. Although the facility's facility rating is 2, the pricing structure suggests that the commercial rates are not merely inflated list prices but reflect the negotiated dynamics of the local market. To ensure you are receiving the most accurate pricing, always request an itemized bill that breaks down the specific CPT code for the blood test rather than accepting a summary invoice. If you receive a bill that appears to include services not rendered or unbundled charges, you have the right to dispute it in writing to avoid unnecessary medical debt.