CMS Price Transparency Data

Blood test, lipase

Facility: Wesley Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $15
  • Cash Discount Price: $535
  • vs. Medicare Baseline: 2.18x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Wesley Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $535. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.18x the Medicare baseline. Located in 550 N Hillside Street, Wichita, KS.
Cash / Self-Pay
$535

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $535 (7765%)
Insurance Median: $15 (218%)
Cash: $535 (7765% of Medicare)
Ins. Median: $15 (218% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 218% of the Medicare baseline (a markup of 118%). 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.

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
Coventry Health Care $7 102%
Ambetter / Centene $7 - $96 102%
UnitedHealthcare $7 102%
Medicaid / KanCare $7 102%
Triwest Health Alliance $7 102%
Humana $7 102%
Devoted Health $7 102%
United $7 - $241 102%
Amerigroup $7 102%
Aetna $7 - $191 102%
Correct Care Solutions $10 145%
Multiplan $15 - $482 218%
First Health $15 - $247 218%
Blue Cross Blue Shield $21 305%
Wppa $93 1350%
Health Partners Of Kansas $93 - $268 1350%
Preferred Health Choices $101 1466%
Medical Associates Health Plan $101 1466%
Spirit Aerosystems $171 2482%
Triwest Healthcare Alliance $348 5051%
Usa Managed Care $455 6604%

Consumer Guidance & Cost Commentary

For the blood test, lipase procedure (CPT 83690) at Wesley Medical Center in Wichita, KS, the cash price is $535.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, as indicated by a ratio of 2.2 times the Medicare benchmark of $6.89. While commercial insurance plans like Coventry Health Care and UnitedHealthcare negotiate rates starting at $7.00, these figures are still below the cash price, suggesting that paying out-of-pocket might not be the most economical option for those with active insurance coverage. However, patients with high-deductible plans should verify if their specific plan's negotiated rate exceeds the cash price, as paying the full $535.00 upfront could result in immediate savings compared to waiting for insurance reimbursement.

It is important to note that the listed cash price of $535.00 represents the standard charge before any potential discounts. Patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window. Additionally, if you have insurance, be aware that while the facility is in-network for many payers, specific lab services or ancillary providers might operate out-of-network, potentially triggering balance billing for the difference between the allowed amount and the full charge. To avoid unexpected costs, always request an itemized bill before signing any consent waivers and dispute any charges that appear incorrect or unbundled, as over 80% of hospital bills contain errors that can be corrected through a formal audit

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 N Hillside Street, Wichita, KS 67214
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals