Blood test, lipase
Facility: Jewell County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $88
- Cash Discount Price: $69
- vs. Medicare Baseline: 12.77x 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 1277% of the Medicare baseline (a markup of 1177%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $78 | 1132% |
| Aetna | $83 | 1205% |
| Meritain - All Plans | $83 | 1205% |
| Midlands Choice - All Plans | $88 | 1277% |
| UnitedHealthcare | $88 | 1277% |
| Cigna | $88 | 1277% |
| First Health - All Plans | $88 | 1277% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the facility's cash price of $69.00 is lower than the negotiated rates of $88.00 paid by major insurers like Aetna, Cigna, and UnitedHealthcare. While commercial insurance contracts often result in higher allowed amounts due to administrative overhead, patients with high-deductible plans may find paying the cash price upfront more cost-effective, as the $69.00 rate avoids the $19.00 difference in the negotiated fee. It is important to note that while this facility is a Critical Access Hospital in Mankato, KS, the data provided does not include specific county or state average comparisons for this service, so the cash price stands as the primary benchmark for self-pay patients.
Patients should be aware that commercial insurance rates can sometimes exceed cash prices, making it worthwhile to inquire about "self-pay" or "prompt-pay" discounts before scheduling. Although the data shows a median negotiated rate of $88.00, which aligns with the median paid amount, verifying the specific discount structure with the hospital can further reduce out-of-pocket costs. Additionally, if you have received a bill, ensure you request a full itemized statement to review every code and unit cost, as summary bills often obscure individual charges that could be disputed.