Blood test, lipase
Facility: Centura St. Catherine-Dodge City
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $202
- Cash Discount Price: $123
- vs. Medicare Baseline: 29.32x 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 2932% of the Medicare baseline (a markup of 2832%). 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 |
|---|---|---|
| Kansas Health | $7 | 102% |
| Kaiser | $7 | 102% |
| Cigna | $7 | 102% |
| Humana | $7 | 102% |
| Aetna | $7 - $246 | 102% |
| Blue Cross Blue Shield | $7 - $33 | 102% |
| Medicare (plans) | $7 | 102% |
| Centura Employee Plan | $9 | 131% |
| UnitedHealthcare | $202 | 2932% |
| Wpaa | $215 | 3120% |
| Christian Health Aid | $246 | 3570% |
| Multiplan | $246 - $276 | 3570% |
| Health Partners Of Kansas | $276 | 4006% |
Consumer Guidance & Cost Commentary
For the blood test procedure (CPT 83690) at Centura St. Catherine-Dodge City, the facility's cash median price of $123.00 is significantly lower than the negotiated rates paid by most insurance plans, which average $202.00. This price difference highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. While the facility's negotiated rate aligns with the state average for this service, the cash price offers a substantial alternative for patients who can pay upfront. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can further reduce the final cost.
When evaluating the financial value of this service, it is more accurate to compare rates against the Medicare benchmark rather than the facility's full chargemaster list. The Medicare amount for this code is $6.89, and the facility's cash rate of $123.00 represents a markup of 29.3% over the Medicare rate, which falls within the range of fair pricing typically defined as 120% to 150% of Medicare. Commercial negotiated rates, averaging 200% to 300% of Medicare, often include administrative overheads that do not reflect the true cost of care. To ensure you are not overpaying, we recommend requesting a detailed, itemized billing statement to review specific C