Blood test, lipase
Facility: Ellinwood District Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $38
- Cash Discount Price: $46
- vs. Medicare Baseline: 5.52x 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 552% of the Medicare baseline (a markup of 452%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $38 | 552% |
| Cigna | $38 | 552% |
| UnitedHealthcare | $38 | 552% |
| Humana | $38 | 552% |
| Aetna | $38 | 552% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Ellinwood District Hospital, the cash price of $46.00 is lower than the negotiated rate of $38.00 paid by major insurers like Blue Cross Blue Shield and Cigna. This 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 if you have a high-deductible plan. Since the facility is a Critical Access Hospital in Kansas, you should verify if your specific insurance plan covers this service and whether your deductible has been met before scheduling. If you choose to pay cash directly, ask the billing department about "prompt-pay" discounts, which can further reduce the final amount owed.
The facility's cash rate of $46.00 is also lower than the Medicare benchmark of $6.89, which serves as the federal baseline for the true cost of this service. While the data shows a "vs_medicare" metric of 5.5, this figure likely reflects a specific calculation method rather than a direct price comparison, so it is best to rely on the cash price for your own financial planning. Because over 80% of hospital bills contain errors, we recommend requesting a full itemized statement before paying to ensure no unbundled charges or services not rendered are included. If you receive a surprise bill, remember that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, and you have the right to dispute any unexpected charges in writing.