Blood test, lipase
Facility: Stormont Vail Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $23
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.34x 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 334% of the Medicare baseline (a markup of 234%). 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 |
|---|---|---|
| Ambetter / Centene | $7 | 102% |
| Blue Cross Blue Shield | $7 - $28 | 102% |
| UnitedHealthcare | $7 | 102% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Stormont Vail Hospital in Topeka, KS, the facility's negotiated payment rate is $23.00, which is significantly lower than the state average of $9685.00. While the hospital's chargemaster gross is $180.00, patients with high-deductible plans should consider that paying cash directly might be more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated amount without meeting your deductible can result in substantial out-of-pocket costs. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront fee reductions can bypass the administrative overhead of the insurance billing cycle and lower the final amount owed.
This service is categorized under laboratory testing, and the data reflects a 2026-06 vintage with a facility rating of 4 out of 5. The Medicare benchmark for this code is $6.89, which serves as the objective baseline for evaluating pricing markups; commercial negotiated rates typically range from 200% to 300% of this amount, though fair pricing is often defined between 120% and 150%. If you receive a bill that appears to include balance billing for out-of-network ancillary services, such as emergency physicians or lab components, you may be entitled to protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. To avoid unexpected