Blood test, creatinine (kidney)
Facility: Aurora Medical Center
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $36
- Cash Discount Price: $34
- vs. Medicare Baseline: 7.03x 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 703% of the Medicare baseline (a markup of 603%). 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 | $4 - $63 | 78% |
| Aurora Caregiver | $5 | 98% |
| Blue Cross Blue Shield | $5 - $64 | 98% |
| Aetna | $11 - $62 | 215% |
| Centivo | $11 | 215% |
| Common Ground | $11 | 215% |
| Health Payment Systems | $13 | 254% |
| Quartz One | $13 | 254% |
| Healthpartners | $14 - $56 | 273% |
| Hs Technology | $14 | 273% |
| Molina Exchange | $14 | 273% |
| Cigna | $15 - $63 | 293% |
| Everpointe Elite | $15 | 293% |
| Quartz Group | $15 | 293% |
| Wisconsin Physician Service | $17 | 332% |
| Trilogy | $18 | 352% |
| Health Eos Plus | $36 - $45 | 703% |
| Health Eos | $48 - $60 | 938% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the cash median rate at Aurora Medical Center in Grafton, WI, is $34, which is significantly lower than the state average of $68. While the facility's median negotiated rate with insurance payers is $36, the cash price remains the most accessible option for patients who do not have insurance or have high-deductible plans where the insurance allowed amount might exceed $34. It is important to note that commercial rates often include administrative overhead, making the direct cash price a benchmark for potential savings.
Patients should verify the specific "self-pay" or "prompt-pay" discount rates offered by the hospital before scheduling, as these upfront discounts can further reduce the $34 cash median. Although the Medicare benchmark for this service is $5.12, which serves as the true cost baseline, the commercial cash rate of $34 reflects the facility's pricing structure independent of insurance contracts. To ensure you are not overcharged, always request an itemized bill that details the exact CPT code (82565) and unit costs, rather than accepting a summary bill that may obscure individual charges or include unbundled services.