Blood test, amylase
Facility: Holton Community Hospital
Billing Code: 82150 (CPT)
- CPT Billing Code: 82150
- Insurance Median: $62
- Cash Discount Price: $56
- vs. Medicare Baseline: 9.57x 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 $6.48 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 957% of the Medicare baseline (a markup of 857%). 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 | $25 | 386% |
| Aetna | $40 - $75 | 617% |
| UnitedHealthcare | $40 - $75 | 617% |
| Humana | $40 | 617% |
| Kansas Superior Select - All Plans | $41 | 633% |
| Preferred Health Freedom | $62 | 957% |
| Preferred Health Fn Select - All Other Plans | $62 | 957% |
| Preferred Health Professionals | $62 | 957% |
| Wppa Providers - All Plans | $71 | 1096% |
| Medicaid / KanCare | $75 | 1157% |
Consumer Guidance & Cost Commentary
For Holton Community Hospital's blood test, amylase (CPT 82150), the cash median price is $56.00, which is significantly lower than the facility's gross charge of $75.00. While the facility's negotiated rates with major payers like Aetna and UnitedHealthcare range between $40.00 and $75.00, the cash price offers a distinct advantage for patients with high-deductible plans who may not yet have met their out-of-pocket limits. In this case, paying cash directly avoids the administrative overhead often embedded in insurance contracts, potentially saving patients money compared to the higher negotiated rates that include claims processing costs. Patients should verify their specific plan's deductible status before scheduling, as using insurance might result in a higher out-of-pocket expense if the negotiated rate exceeds the cash price.
To ensure you are receiving fair pricing, it is important to compare these rates against the Medicare benchmark, which serves as the objective baseline for healthcare costs. The Medicare amount for this service is $6.48, and the facility's cash rate of $56.00 represents a markup of 9.6 times the Medicare rate. While commercial negotiated rates typically average 200% to 300% of Medicare, fair pricing is generally defined as 120% to 150% of the Medicare amount. Additionally, you should inquire about "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full upfront, bypassing the costly insurance billing cycle. Always request an itemized bill to review specific CPT codes and avoid paying for services not rendered