Blood test, lipase
Facility: Kansas City Orthopaedic Institute
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $22
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.19x 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 319% of the Medicare baseline (a markup of 219%). 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 |
|---|---|---|
| Aetna | $7 | 102% |
| UnitedHealthcare | $7 - $44 | 102% |
| Cigna | $7 - $37 | 102% |
| Blue Cross Blue Shield | $9 - $48 | 131% |
| Medica | $39 - $41 | 566% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $7 to $48 across five major payers, with a median negotiated rate of $22.00. This facility is owned by a physician and operates as an acute care hospital. While the data does not provide specific cash or median paid amounts for this service, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs than insurance negotiated rates, particularly for those with high-deductible plans. It is important to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront incentives can bypass the administrative overhead and claim processing costs that often inflate insurance billing structures.
When evaluating the cost of this service, it is crucial to compare rates against objective benchmarks rather than the facility's inflated chargemaster list. The Medicare amount for this procedure is $6.89, which serves as a scientifically validated baseline for the true cost of delivery. Commercial negotiated rates often exceed fair pricing thresholds, and patients should avoid assuming that an in-network status guarantees the lowest possible price, as rates vary significantly by payer contract. Furthermore, if a patient receives care from an out-of-network provider at this facility, they may face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act provides federal protections against such surprise bills for emergency and non-emergency services at in-network facilities.