Blood test, lipase
Facility: Rawlins County Health Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $74
- Cash Discount Price: $72
- vs. Medicare Baseline: 10.74x 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 1074% of the Medicare baseline (a markup of 974%). 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 | $28 | 406% |
| UnitedHealthcare | $74 | 1074% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Rawlins County Health Center in Atwood, KS, the facility's cash median price is $72.00, which is lower than the gross charge of $85.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates for in-network payers like Blue Cross Blue Shield and UnitedHealthcare are set at $74.00. This negotiated amount is slightly higher than the cash price, illustrating a scenario where paying out-of-pocket might be more cost-effective for patients with high-deductible plans who have not yet met their coverage thresholds. It is important to note that the facility's negotiated rate of $74.00 is significantly higher than the Medicare benchmark of $6.89, reflecting the typical administrative markup and contract dynamics that commercial insurance rates carry compared to federal reimbursement standards.
When evaluating costs against regional standards, the facility's cash rate of $72.00 remains the primary benchmark for self-pay patients, as the data does not provide specific county or state average comparisons for this specific service. However, the gap between the gross charge and the negotiated rate highlights the importance of verifying "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing costly claims processing. Patients should avoid assuming that being in-network guarantees the lowest possible price, as some facilities charge substantially more than others for the same service. To ensure accuracy, consumers are encouraged to request an itemized bill that breaks down the specific CPT code and any ancillary charges, allowing for a