CMS Price Transparency Data

Blood test, lipase

Facility: Lane County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $60
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 8.71x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Lane County Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.71x the Medicare baseline. Located in 235 West Vine Po Box 969, Dighton, KS.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $60 (871%)
Insurance Median: $60 (871%)
Cash: $60 (871% of Medicare)
Ins. Median: $60 (871% of 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 871% of the Medicare baseline (a markup of 771%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
UnitedHealthcare $54 - $60 784%
Aetna $54 - $57 784%
Healthy Blue Mcr Adv - All Other Plans $60 871%
Healthy Blue Mcaid $60 871%
Medicaid / KanCare $60 - $66 871%
Wppa Providers-All Plans $90 1306%

Consumer Guidance & Cost Commentary

For the CPT code 83690 (Blood test, lipase) at Lane County Hospital in Dighton, KS, the cash price is $60.00, which matches the facility's negotiated rates with UnitedHealthcare, Aetna, and Healthy Blue plans. This cash price is significantly higher than the Medicare benchmark of $6.89, indicating a markup of 8.7 times the federal rate. While commercial insurance contracts often cap payments at negotiated rates that can exceed cash prices, patients with high-deductible plans may find paying the $60.00 cash price directly more cost-effective than relying on insurance, especially if their plan's allowed amount is higher than the cash rate.

To minimize potential costs, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these programs can reduce bills by 20% to 50% for upfront payment. It is also important to request a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled charges or services not rendered. If a patient receives a balance bill for out-of-network ancillary services, they should not pay immediately but instead dispute the charge with their insurer under the No Surprises Act to avoid unexpected costs.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 235 West Vine Po Box 969, Dighton, KS 67839
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals