Blood test, creatinine (kidney)
Facility: Golden Valley Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $5
- Cash Discount Price: $31
- vs. Medicare Baseline: 0.98x 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.
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 |
|---|---|---|
| Aetna | $5 | 98% |
| Home State Health | $5 | 98% |
| Humana | $5 | 98% |
| UnitedHealthcare | $5 - $9 | 98% |
| Ambetter / Centene | $6 | 117% |
Consumer Guidance & Cost Commentary
If you are paying out of pocket for this blood test, the most important thing to know is that the facility offers a cash price of $31, which is significantly lower than the typical negotiated rates charged to most insurance plans. While the facility's cash rate is higher than the state average of $5 and the county average of $5, patients with high-deductible plans may find that paying the cash price directly is still more cost-effective than facing a negotiated rate that could exceed $50, as some insurance payers list rates as high as $9. It is crucial to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling your visit, as paying in full upfront can often reduce the final amount due through immediate liquidity incentives that bypass standard claims processing fees.
The broader pricing context reveals that this procedure carries a gross charge of $51, which serves as the base list price before any discounts are applied. When compared to the Medicare benchmark of $5.12, the facility's gross rate represents a substantial markup, highlighting the difference between the federal cost baseline and commercial pricing. Although the median negotiated rate across all payers is only $5, individual payer contracts vary, with some plans showing a high of $9 and others at $6, meaning the actual amount billed to an insured patient depends entirely on their specific plan tier. To ensure you receive the best possible price, always request an itemized bill to review specific CPT codes and avoid summary bills that may obscure errors or unbundled charges, and remember that federal protections like the No Surprises Act may apply if any ancillary services are rendered by out-of-network providers.