Blood test, lipase
Facility: F W Huston Medical Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $66
- Cash Discount Price: $69
- vs. Medicare Baseline: 9.58x 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 958% of the Medicare baseline (a markup of 858%). 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% |
| Aetna | $64 | 929% |
| Humana | $68 | 987% |
| Cigna | $73 | 1060% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at F W Huston Medical Center in Winchester, KS, the facility's cash median rate of $69.00 is notably higher than the state average of $66.00, though it aligns closely with the median negotiated rate of $66.00. While commercial payers like Blue Cross Blue Shield, Aetna, Humana, and Cigna all have a single plan paying exactly $28, $64, $68, and $73 respectively, patients should consider that paying cash upfront might be more cost-effective if their insurance deductible is high or if the negotiated rate exceeds the cash price. Since this facility is a Critical Access Hospital with a voluntary non-profit ownership, it is advisable to ask directly about "self-pay" or "prompt-pay" discounts before scheduling, as these programs can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
When reviewing your final invoice, ensure you receive a detailed itemized bill rather than a summary statement, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed. If you encounter a balance bill for the difference between the provider's chargemaster and your insurance allowed amount, remember that the No Surprises Act generally protects you from these unexpected charges for emergency care and non-emergency services at in-network facilities. To verify if the facility's pricing is fair, compare the commercial rates to the Medicare benchmark of $6.89; while commercial rates often average 200% to 300% of Medicare,