Blood test, lipase
Facility: Rooks County Health Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $83
- Cash Discount Price: $69
- vs. Medicare Baseline: 12.05x 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 1205% of the Medicare baseline (a markup of 1105%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $6 | 87% |
| Blue Cross Blue Shield | $28 | 406% |
| Tricare | $43 | 624% |
| Celtic Mcr Adv | $43 | 624% |
| Celtic Comm - All Other Plans | $47 | 682% |
| Preferred Benefits Admin | $83 | 1205% |
| Aetna | $83 | 1205% |
| UnitedHealthcare | $83 | 1205% |
| Preferred Hlthcare - All Other Plans | $87 | 1263% |
| Health Partners - All Plans | $87 | 1263% |
| Healthy Blue Mcaid - All Plans | $92 | 1335% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at Rooks County Health Center in Plainville, KS, the facility's cash median rate is $69.00, which is lower than the state average of $92.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield, Tricare, and Aetna average $83.00, patients with high-deductible plans may find paying the cash price of $69.00 directly more cost-effective than relying on insurance, as the negotiated amounts often exceed the cash rate. Because this facility is a Critical Access Hospital owned by a Government Hospital District, it is important to verify your specific plan's status before scheduling, as some out-of-network services or ancillary tests could potentially trigger balance billing if not properly coordinated.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices can hide unbundled codes or services that were never rendered. If you receive a bill for the difference between the provider's full charge and your insurance allowed amount, you may be eligible for protections under the No Surprises Act, which bans balance billing for emergency and non-emergency services at in-network facilities. Additionally, since the facility offers prompt-pay discounts for upfront payment, you should contact the billing department before check-in to confirm if a self-pay discount is available, which could further reduce the cost below the $69.00 cash median.