Blood test, lipase
Facility: Mercy Hospital Columbus
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $58
- Cash Discount Price: $47
- vs. Medicare Baseline: 8.42x 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 842% of the Medicare baseline (a markup of 742%). 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 |
|---|---|---|
| UnitedHealthcare | $6 - $69 | 87% |
| Blue Cross Blue Shield | $6 - $36 | 87% |
| Humana | $6 - $79 | 87% |
| Medicaid / KanCare | $6 - $60 | 87% |
| Provider Partners Health Plans Contracted [320450] | $7 | 102% |
| Medical Associates Health Contracted [320444] | $7 | 102% |
| Cigna | $7 | 102% |
| Dept Of Veteran Affairs Contracted [320106] | $7 | 102% |
| Ambetter / Centene | $7 - $60 | 102% |
| Halo Hcr Inc Hospice Contracted [320432] | $7 | 102% |
| Pace Of The Ozarks Contracted [320518] | $7 | 102% |
| Mercy Mgd Behavioral Health Contracted [320259] | $7 | 102% |
| Medicare (plans) | $7 - $60 | 102% |
| Qual Choice Contracted [320325] | $7 | 102% |
| Elara Caring Aspire Hospice [20433] | $7 | 102% |
| Cherokee Nation Health Serv Contracted [320066] | $7 | 102% |
| Mercy Hospice Okc [20252] | $7 | 102% |
| Halo Hcr Inc Hospice [20432] | $7 | 102% |
| Kindful Hospice Contracted [320434] | $7 | 102% |
| Indian Health Service Contracted [320198] | $7 | 102% |
| Centurion Of Missouri [20459] | $7 | 102% |
| Home State Health Plan Contracted [320187] | $7 | 102% |
| Kindful Hospice [20434] | $7 | 102% |
| Cross Timbers Hospice [20098] | $7 | 102% |
| Healthscope Contracted [320182] | $8 | 116% |
| Centivo Contracted [320505] | $11 | 160% |
| Health Systems Inc Contracted [320174] | $26 - $36 | 377% |
| Insurance System Inc Contracted [320465] | $26 - $36 | 377% |
| Administrative Payor Contracted [320005] | $27 - $37 | 392% |
| Globalhealth Contracted [320145] | $44 - $60 | 639% |
| Aetna | $44 - $75 | 639% |
| Novasys Contracted [320285] | $44 - $60 | 639% |
| Tricare | $44 - $60 | 639% |
| Workers Comp [20426] | $49 - $71 | 711% |
| United Medical Resources Contracted [320454] | $51 - $79 | 740% |
| Medica Contracted [320239] | $55 - $74 | 798% |
| Mercy Benefit Admin Contracted [320251] | $55 - $79 | 798% |
| Federal Medical Center Contracted [320127] | $55 - $75 | 798% |
| American Healthcare Alliance Contracted [320020] | $55 - $75 | 798% |
| Healthlink Contracted [320179] | $55 - $79 | 798% |
| Preferred Health Plan Contracted [320522] | $55 - $75 | 798% |
| Usa Managed Care Org Contracted [320429] | $55 - $75 | 798% |
| First Health Contracted [320128] | $55 - $75 | 798% |
| Show-Me Health Administrators Contracted [320483] | $58 - $79 | 842% |
| Auxiant Contracted [320462] | $58 - $79 | 842% |
| Point C Contracted [320238] | $58 - $79 | 842% |
| Ebms Contracted [320493] | $58 - $79 | 842% |
| Imagine 360 Contracted [320494] | $58 - $79 | 842% |
| Reflect Health Contracted [320492] | $58 - $79 | 842% |
| Private Health Care Systems Contracted [320320] | $58 - $79 | 842% |
| Edison Health Solutions Contracted [320502] | $58 - $79 | 842% |
| Ppo Plus Contracted [320310] | $58 - $79 | 842% |
| Yuzu Health Contracted [320521] | $58 - $79 | 842% |
| Aither Health Contracted [320449] | $58 - $79 | 842% |
| 90 Degree Benefits Contracted [320436] | $58 - $79 | 842% |
| Benefit Management Contracted [320052] | $58 - $79 | 842% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase), Mercy Hospital Columbus lists a cash price of $47.00, which is lower than the facility's gross charge of $72.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $6 to $79, the cash price may offer a better value for patients with high-deductible plans or those without insurance, as the cash rate is significantly below the typical negotiated amounts. It is important to note that commercial rates often include administrative overhead and contract markups that can exceed the Medicare benchmark of $6.89, so comparing the cash price directly to the Medicare rate provides a clearer picture of the facility's baseline cost.
Patients should verify if their specific insurance plan has a lower negotiated rate than the cash price, as some plans may pay less than the cash amount, potentially leaving the patient responsible for balance billing if they are out-of-network. Although the No Surprises Act protects against balance billing for emergency services at in-network facilities, it is crucial to request an itemized bill to ensure no unbundled codes or services not rendered are included. Additionally, patients should ask the billing department about prompt-pay discounts, which can reduce the final cost by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.