Blood test, creatinine (kidney)
Facility: Children'S Mercy South
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $39
- Cash Discount Price: $29
- vs. Medicare Baseline: 7.62x 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 762% of the Medicare baseline (a markup of 662%). 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 - $40 | 98% |
| Medicaid / KanCare | $6 | 117% |
| Healthy Blue | $6 - $14 | 117% |
| Home State Health | $12 | 234% |
| Blue Cross Blue Shield | $25 - $44 | 488% |
| Cigna | $29 - $42 | 566% |
| Medica | $35 | 684% |
| Aetna | $36 - $41 | 703% |
| Wellfit/Centrus | $39 | 762% |
| Quiktrip | $39 | 762% |
| Health Midwest Comprehensive Care | $39 | 762% |
| Wppa Providrs Care | $39 | 762% |
| Orscheln | $39 | 762% |
| Centivo | $39 | 762% |
| Nebraska Furniture Mart | $39 | 762% |
| Humana | $40 | 781% |
| Coxhealth Network | $44 | 859% |
| Coventry Health Care Of Kansas | $44 | 859% |
| Mercy Health | $45 | 879% |
| Multiplan | $46 | 898% |
| American Healthcare Alliance | $51 | 996% |
| Healthlink | $53 | 1035% |
| National Preferred Provider Network | $54 | 1055% |
Consumer Guidance & Cost Commentary
For the blood test, creatinine (kidney) procedure at Children's Mercy South in Overland Park, KS, the facility's cash median price is $29.00, which is significantly lower than the state average of $39.00. While many commercial payers have negotiated rates ranging from $5 to $54, the cash price remains the most affordable option for patients without insurance. This aligns with the principle that cash-pay can sometimes be cheaper than insurance for those with high-deductible plans, as the negotiated rates often exceed the cash price due to administrative overhead and contract dynamics. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated amount may not be cost-effective if the deductible has not yet been met.
To avoid unexpected costs, consumers should request a full itemized CPT-coded bill rather than accepting summary invoices, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If a patient receives a balance bill for out-of-network services, they should not pay immediately out of fear of credit damage; instead, they should dispute the bill with their insurer and request a No Surprises Act audit. Additionally, patients can often reduce their out-of-pocket expenses by asking the facility about "self-pay" or "prompt-pay" discounts, which typically range from 20% to 50% off the billed amount when paid upfront, bypassing the costly claims processing cycle.