Blood test, creatinine (kidney)
Facility: Susan B Allen Memorial Hospital
Billing Code: 82565 (CPT)
- CPT Billing Code: 82565
- Insurance Median: $554
- Cash Discount Price: $13
- vs. Medicare Baseline: 108.20x 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 10820% of the Medicare baseline (a markup of 10720%). 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 | $350 | 6836% |
| Providrs Care | $757 | 14785% |
Consumer Guidance & Cost Commentary
For the blood test for creatinine at Susan B Allen Memorial Hospital in El Dorado, Kansas, the cash median price is $13.00, which is significantly lower than the facility's negotiated rates of $554.00. While the facility's negotiated rate is higher than the cash price, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that the facility's negotiated rate of $554.00 is substantially higher than the state average of $5.12 (Medicare amount) and the county average of $13.00 (cash median). Patients should verify their specific plan's allowed amount before scheduling, as commercial negotiated rates often include administrative overhead that can inflate the baseline price compared to direct cash payments.
If you choose to use insurance, be aware that the facility's negotiated rate of $554.00 is based on contracts with UnitedHealthcare and Providrs Care, which set a ceiling to protect in-network members. However, if you are out-of-network or if specific services like laboratory tests are billed separately, you could face balance billing for the difference between the provider's full chargemaster rate and what your insurance pays. Under the No Surprises Act, balance billing for emergency care and non-emergency services at in-network facilities is generally prohibited, but it is crucial to request an itemized billing audit if you receive a summary bill that obscures individual CPT codes or unbundled charges. To minimize costs, consider asking the hospital about prompt-pay discounts for self-pay patients, which can reduce the bill by 20% to 50% if