Blood test, lipase
Facility: Lmh
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $7
- Cash Discount Price: $61
- vs. Medicare Baseline: 1.02x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $6 - $157 | 87% |
| UnitedHealthcare | $6 - $46 | 87% |
| Medicare (plans) | $7 | 102% |
| Cigna | $7 - $162 | 102% |
| Haskell Indian Health Services | $7 | 102% |
| Allwell | $7 | 102% |
| Humana | $7 | 102% |
| Aetna | $8 - $201 | 116% |
| Ambetter / Centene | $11 | 160% |
| Non Contracted | $194 | 2816% |
| First Health | $226 | 3280% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the facility's cash price of $61.00 is significantly lower than the negotiated rates charged by major insurers like Blue Cross Blue Shield, UnitedHealthcare, and Aetna, which range from $6 to over $200 depending on the plan. While the facility is government-owned and located in Lawrence, Kansas, the cash rate offers a substantial discount compared to the commercial contracts that include administrative overhead and claims processing costs. Patients with high-deductible plans may find this cash price more affordable than their insurance allowed amounts, provided they can secure a "self-pay" or "prompt-pay" discount before scheduling to avoid being billed the full negotiated rate by their insurer.
It is important to note that while the facility's cash rate is competitive, the presence of a "Non Contracted" payer at $194 and a "First Health" rate at $226 highlights that out-of-network or non-negotiated scenarios can result in much higher costs. Under federal protections like the No Surprises Act, patients should not be balance billed for out-of-network services at in-network facilities, but they should still verify their specific plan's allowed amount before receiving care. To ensure the lowest possible cost, patients are encouraged to request an itemized bill to review every code and service, as summary bills often obscure individual charges, and to explicitly ask for a prompt-pay discount during registration to bypass standard insurance billing cycles.