CMS Price Transparency Data

Blood test, lipase

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $11
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Hospital Pittsburg, Inc is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.60x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $124 (1800%)
Insurance Median: $11 (160%)
Cash: $124 (1800% of Medicare)
Ins. Median: $11 (160% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.89 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $6 - $162 87%
Medicaid / KanCare $6 - $12 87%
UnitedHealthcare $6 - $129 87%
Humana $6 - $7 87%
Mercy Hospice Okc [20252] $7 102%
Medica Contracted [320239] $7 102%
American Health Advantage Of Ks Mcr Contracted [320508] $7 102%
Halo Hcr Inc Hospice [20432] $7 102%
Kindful Hospice Contracted [320434] $7 102%
Tricare $7 102%
Pace Of The Ozarks Contracted [320518] $7 102%
Blue Cross Blue Shield $7 - $33 102%
Dept Of Veteran Affairs Contracted [320106] $7 102%
Kindful Hospice [20434] $7 102%
Medicare (plans) $7 102%
Halo Hcr Inc Hospice Contracted [320432] $7 102%
Elara Caring Aspire Hospice [20433] $7 102%
Cross Timbers Hospice [20098] $7 102%
Health Choice Contracted [320166] $9 131%
Home State Health Plan Contracted [320187] $12 174%
Ambetter / Centene $12 174%
Providrs Care Network Contracted [320484] $13 189%
Cigna $38 - $39 552%
United Medical Resources Contracted [320454] $129 1872%
Healthlink Contracted [320179] $153 2221%
Ebms Contracted [320493] $153 2221%
Aither Health Contracted [320449] $153 2221%
Workers Comp [20426] $153 2221%
Yuzu Health Contracted [320521] $153 2221%
Edison Health Solutions Contracted [320502] $153 2221%
Imagine 360 Contracted [320494] $153 2221%
Reflect Health Contracted [320492] $153 2221%
Auxiant Contracted [320462] $153 2221%
Mercy Benefit Admin Contracted [320251] $153 2221%
American Healthcare Alliance Contracted [320020] $153 2221%
First Health Contracted [320128] $162 2351%

Consumer Guidance & Cost Commentary

For the CPT code 83690, representing a blood test for lipase, Mercy Hospital Pittsburg, Inc. lists a gross charge of $191.00, which is significantly higher than the Medicare benchmark rate of $6.89. While the facility's cash median price is $124.00 and the median negotiated rate across payers is $11.00, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and network tiering. The data indicates that while some payers like Medicaid/KanCare have negotiated rates as low as $6, others such as United Medical Resources and Healthlink charge the maximum gross amount of $129.00 and $153.00 respectively, highlighting the variability in in-network pricing.

To minimize costs, patients should verify their specific plan's deductible status before scheduling, as paying the cash price of $124.00 may be more economical if their insurance negotiated rate exceeds this amount or if they have not yet met their deductible. Additionally, asking the hospital directly about "self-pay" or "prompt-pay" discounts prior to check-in can often reduce the final bill, as these incentives bypass the costly insurance claims processing cycle. It is important to request a full itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies, and to avoid balance billing surprises by confirming that all services, including ancillary lab work, are covered under the No Surprises Act protections.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals