Blood test, lipase
Facility: Ashland Health Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $40
- Cash Discount Price: $32
- vs. Medicare Baseline: 5.81x 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 581% of the Medicare baseline (a markup of 481%). 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 | $13 | 189% |
| Compalliance-All Plans | $32 | 464% |
| Health Partners Of Kansas-All Plans | $34 | 493% |
| Multiplan-All Plans | $39 | 566% |
| Medicare (plans) | $40 | 581% |
| Health Choice-All Plans | $40 | 581% |
| Medicaid / KanCare | $40 | 581% |
| UnitedHealthcare | $40 | 581% |
| Medica Mcare - All Plans | $40 | 581% |
| Aetna | $40 | 581% |
| Healthy Blue Mcr Adv - All Other Plans | $40 | 581% |
| Providers Care (Wppa)-All Plans | $60 | 871% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Ashland Health Center in Ashland, KS, the facility's cash median rate is $32.00, which is lower than the negotiated rates paid by most insurance plans. While the facility's negotiated average is $40.00, several payers, including Blue Cross Blue Shield and Compalliance-All Plans, pay exactly $13.00 and $32.00 respectively, indicating significant variation in commercial contracts. For patients with high-deductible plans, paying the cash price of $32.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. Additionally, patients should verify if the facility offers self-pay or prompt-pay discounts, which can further reduce the final amount owed before any insurance processing occurs.
The Medicare benchmark for this procedure is $6.89, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $32.00 represents a markup relative to the Medicare rate, consistent with commercial pricing dynamics where negotiated rates typically range from 200% to 300% of Medicare amounts. While the data does not provide specific county or state average comparisons for this exact code, the facility's cash rate remains competitive when compared to the lower end of the payer range, with some plans paying as low as $13.00. To ensure accurate billing, patients should request an itemized bill to confirm that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal