Blood test, lipase
Facility: Cheyenne County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $39
- Cash Discount Price: $41
- vs. Medicare Baseline: 5.66x 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 566% of the Medicare baseline (a markup of 466%). 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 | $3 - $41 | 44% |
| Blue Cross Blue Shield | $28 | 406% |
| First Health - All Plans | $29 | 421% |
| Healthy Blue Mcr Adv | $30 | 435% |
| Choice Care - All Plans | $30 | 435% |
| Tricare | $30 | 435% |
| Aetna | $30 - $39 | 435% |
| Firstguard - All Plans | $33 | 479% |
| Wppa - All Plans | $37 | 537% |
| Preferred Hc - All Plans | $39 | 566% |
| Cpm - All Plans | $39 | 566% |
| Ppo Next - All Plans | $40 | 581% |
| Health Partners - All Plans | $40 | 581% |
| Midlands Choice - All Plans | $40 | 581% |
| Unicare - All Plans | $40 | 581% |
| Integrated Hp - All Plans | $40 | 581% |
| Childrens Mercy - All Plans | $41 | 595% |
| Healthy Blue Mcaid - All Other Plans | $41 | 595% |
| Healthwave Mcaid - All Plans | $41 | 595% |
| Providers Care-All Plans | $62 | 900% |
Consumer Guidance & Cost Commentary
For CPT code 83690, a blood test for lipase, Cheyenne County Hospital in St. Francis, KS, lists a cash price of $41.00. This cash rate aligns exactly with the facility's median negotiated rate of $39.00 and the cash median for the state, suggesting that paying out-of-pocket may be the most cost-effective option for patients with high-deductible plans. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the cash price does not exceed the state average, and patients should verify if their specific insurance plan has a negotiated rate that exceeds $41.00 before scheduling, as commercial contracts often include administrative overhead that can inflate the final allowed amount.
The facility's pricing is significantly lower than the Medicare benchmark for this service, which is set at $6.89, indicating that the commercial rates charged are well above the federal baseline. However, because the cash price of $41.00 is higher than the Medicare amount of $6.89, patients should be aware that Medicare rates serve as a cost baseline rather than a target for commercial pricing. To ensure you receive the best possible rate, it is recommended to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can sometimes reduce the final bill further. Additionally, since the facility is in-network for twenty payers, patients should review their specific plan details to avoid unexpected balance billing, though the No Surprises Act generally protects against such charges for emergency or non-emergency services at in-network facilities.