CMS Price Transparency Data

Blood test, amylase

Facility: Nemaha Valley Community Hospital

Billing Code: 82150 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82150
  • Insurance Median: $33
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 5.09x Medicare
The contracted insurance negotiated median rate for a Blood test, amylase at Nemaha Valley Community Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $6.48, this hospital’s rate is 5.09x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.48

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.48 (100%)
Cash / Self-Pay: $58 (895%)
Insurance Median: $33 (509%)
Cash: $58 (895% of Medicare)
Ins. Median: $33 (509% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.48 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 509% of the Medicare baseline (a markup of 409%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Va Ccn - All Plans $4 62%
Humana $28 432%
Aetna $28 - $54 432%
Celtic Comm Exch - All Plans $31 478%
Partners Direct Health - All Plans $33 509%
Multiplan - All Plans $58 895%
Midlands Choice - All Plans $61 941%
Health Partners - All Plans $61 941%

Consumer Guidance & Cost Commentary

For CPT code 82150, a blood test for amylase, Nemaha Valley Community Hospital in Seneca, KS, lists a cash median price of $58.00, which is notably lower than the facility's gross charge of $64.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, Aetna's negotiated range spans from $28 to $54, and Multiplan's rate is $58, meaning patients with high-deductible plans might save money by paying the cash price directly, provided they confirm the facility accepts their specific plan. It is important to verify "self-pay" or "prompt-pay" discounts with the hospital before scheduling, as these upfront incentives can further reduce the final amount owed.

When comparing pricing against federal benchmarks, the Medicare amount for this service is $6.48, which serves as a baseline for evaluating the facility's markup. The facility's cash median of $58.00 represents a significant increase over the Medicare rate, reflecting the costs of local labor and facility operations. Patients should avoid relying on the hospital's gross charge list as a benchmark, as these figures are inflated to make discounts appear larger than they are; instead, comparing rates to the Medicare amount reveals the true cost structure. Additionally, if a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing, though the No Surprises Act provides federal protections against surprise bills for emergency and non-emergency services at in-network facilities. To ensure accuracy, consumers

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals