Blood test, lipase
Facility: Kansas Medical Center Llc
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $7
- Cash Discount Price: $42
- 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 |
|---|---|---|
| United | $3 | 44% |
| Indian Health | $6 | 87% |
| Medicaid / KanCare | $7 | 102% |
| Medadv_Wellcare | $7 | 102% |
| Blue Cross Blue Shield | $7 - $17 | 102% |
| Ambetter / Centene | $7 | 102% |
| Humana | $7 | 102% |
| Three_Rivers | $14 | 203% |
| Wppa | $18 - $38 | 261% |
| Aetna | $22 | 319% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Kansas Medical Center Llc in Andover, the facility's cash median price of $42.00 is significantly lower than the state average for Kansas Medical Centers, which is $69.00. While the facility's negotiated rates with major payers like United and Indian Health range from $3.00 to $7.00, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $42.00 rate avoids the administrative overhead and potential balance billing associated with insurance claims processing. It is important to note that while the facility offers a cash median of $42.00, the actual self-pay or prompt-pay discount could be lower if requested before check-in, potentially reducing the cost further by bypassing the standard billing cycle.
The facility's Medicare benchmarking rate of $6.89 serves as a critical baseline for understanding pricing markup, as commercial negotiated rates often exceed this federal standard. In this case, the facility's cash price of $42.00 is roughly six times the Medicare rate, reflecting the specific cost dynamics of in-state care versus federal reimbursement. Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. To ensure transparency, consumers should request an itemized bill before paying, verifying that all charges correspond to services actually rendered, and disputing any errors in writing to avoid unnecessary debt.