Blood test, lipase
Facility: Mcpherson Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $45
- Cash Discount Price: $65
- vs. Medicare Baseline: 6.53x 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 653% of the Medicare baseline (a markup of 553%). 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 |
|---|---|---|
| Tricare | $6 | 87% |
| Healthy Blue Mcr Adv | $7 | 102% |
| UnitedHealthcare | $7 - $160 | 102% |
| Wellcare Mcr Adv - All Plans | $7 | 102% |
| Va Ccn - All Plans | $7 | 102% |
| Blue Cross Blue Shield | $7 | 102% |
| Humana | $7 | 102% |
| Ambetter / Centene | $8 | 116% |
| Wppa - All Plans | $27 - $112 | 392% |
| Central Plains - All Plans | $29 - $120 | 421% |
| Medical Associates - All Plans | $29 - $120 | 421% |
| Christian Health Aid - All Plans | $31 - $128 | 450% |
| Aetna | $32 - $160 | 464% |
| Multiplan - All Plans | $35 - $144 | 508% |
| First Health - All Plans | $37 - $152 | 537% |
| Cigna | $37 - $152 | 537% |
| Health Partners - All Plans | $37 - $152 | 537% |
| Medicaid / KanCare | $39 - $160 | 566% |
| Health Blue Mcaid - All Other Plans | $40 - $163 | 581% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at McPherson Hospital in Mcpherson, KS, the facility's cash median rate is $65.00, which is lower than the state average of $89.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $7 to $160, these amounts often exceed the cash price, meaning patients with high-deductible plans may save money by paying the cash rate directly. It is important to note that cash-pay can sometimes be cheaper than insurance reimbursement if the negotiated rate exceeds the cash price, so patients should verify their specific plan's allowed amount before scheduling. Additionally, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer a fee reduction of 20% to 50% for upfront payment, effectively bypassing the administrative costs associated with insurance claims processing.
The facility's Medicare benchmark rate is $6.89, and the median amount paid by insurance is $44.00, which is significantly higher than the Medicare baseline. This disparity highlights that commercial negotiated rates often include administrative overhead and contract dynamics that inflate the baseline price beyond the true cost of care. To ensure transparency, patients should request an itemized billing audit to review the specific CPT codes and unit costs, as over 80% of hospital bills contain errors such as double-billing or unbundled charges. If a patient receives a balance bill for services rendered at an in-network facility, they may be entitled to protections under the No Surprises Act, which bans balance billing for out-of-network providers at in