Blood test, lipase
Facility: Kansas Heart Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $7
- Cash Discount Price: $29
- 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 |
|---|---|---|
| Aetna | $3 | 44% |
| Tricare | $6 | 87% |
| Medicaid / KanCare | $7 | 102% |
| UnitedHealthcare | $7 | 102% |
| Celtic Mcr Adv | $7 | 102% |
| Humana | $7 | 102% |
| Wppa - All Plans | $18 | 261% |
| Blue Cross Blue Shield | $19 | 276% |
| Multiplan - All Plans | $41 | 595% |
Consumer Guidance & Cost Commentary
For the CPT code 83690, representing a blood test for lipase at Kansas Heart Hospital in Wichita, the facility's cash median price is $29.00, while the median negotiated rate across nine payers is $7.00. This cash price is significantly lower than the facility's gross charge of $46.00 and aligns closely with the state average, offering a potential financial advantage for patients with high-deductible plans or those without insurance. Since the cash rate is lower than the negotiated amounts, patients with active coverage may still benefit from paying out-of-pocket if their insurance deductible has not yet been met or if the allowed amount exceeds the cash price. It is advisable to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final cost before services are rendered.
This service is benchmarked against the federal Medicare rate of $6.89, which serves as the objective baseline for evaluating hospital pricing markups. While the facility's cash rate of $29.00 is higher than the Medicare amount, it remains substantially below the gross chargemaster, illustrating how commercial contracts and cash pricing differ from federal reimbursement standards. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network emergency services at in-network facilities, it is crucial to request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included. Disputing any discrepancies in writing with the billing supervisor is the most effective way to ensure the final invoice reflects the true cost of care.