Blood test, creatinine (kidney)
Facility: Oakleaf Surgical Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $5
- Cash Discount Price: $49
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $5 | 98% |
| Dean Health Plan | $5 | 98% |
| Group Health Cooperative Of Eau Claire | $5 | 98% |
| Healthpartners | $5 | 98% |
| Humana | $5 | 98% |
| Medica | $5 | 98% |
| Quartz Health Solutions | $5 | 98% |
| Security Health Plan Of Wi | $5 | 98% |
| Ucare Wi | $5 | 98% |
| UnitedHealthcare | $5 | 98% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Oakleaf Surgical Hospital in Altoona, the cash price of $49 is significantly lower than the facility's gross charge of $54. While the hospital is an acute care facility owned by physicians, there is no state or county average provided for this specific service in the current data. The negotiated rate of $5 aligns with the rates paid by all ten insurance carriers listed, including Blue Cross Blue Shield and UnitedHealthcare, meaning in-network members will not receive a discounted rate compared to self-pay patients.
The Medicare benchmark for this service is $5.12, which serves as the objective baseline for evaluating pricing markups. Since the facility's cash price of $49 is higher than the Medicare rate, patients with high-deductible plans may find it more cost-effective to pay the cash price directly rather than using insurance, as the commercial negotiated rate of $5 is lower than the cash price. To minimize costs further, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50%. Additionally, patients should request an itemized billing audit before paying any final invoice to ensure no errors or unbundled charges are included in the total.