Blood test, lipase
Facility: Pratt Regional Medical Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $96
- Cash Discount Price: $74
- vs. Medicare Baseline: 13.93x 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 $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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1393% of the Medicare baseline (a markup of 1293%). 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 |
|---|---|---|
| Christian Health Aid | $73 - $86 | 1060% |
| UnitedHealthcare | $81 - $116 | 1176% |
| Health Partners Of Kansas | $82 - $97 | 1190% |
| Aetna | $87 - $103 | 1263% |
| Choicecare | $97 - $114 | 1408% |
Consumer Guidance & Cost Commentary
For the blood test code 83690 (lipase) at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price of $74.00 is notably lower than the state average, which sits at $106.00. While commercial insurance plans like Christian Health Aid and Health Partners Of Kansas have negotiated rates ranging from $73 to $116, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated ceiling can be significantly higher than the self-pay amount. To secure the lowest possible cost, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The facility's pricing is also evaluated against the Medicare benchmark, which serves as the objective baseline for healthcare costs. For this specific service, the Medicare amount is $6.89, and the facility's cash rate is approximately 13.9% higher than this federal standard. Although commercial rates are typically 200% to 300% of Medicare, the cash price here remains relatively close to the Medicare benchmark, suggesting a more transparent pricing structure compared to typical commercial markups. Consumers should be aware that while in-network insurance contracts provide a ceiling on charges, they do not guarantee the lowest price; verifying the allowed amount against the cash rate before scheduling is essential to avoid unexpected costs.