CMS Price Transparency Data

Blood test, lipase

Facility: Hamilton County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $71
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 10.30x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Hamilton County Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.30x the Medicare baseline. Located in 700 North Huser Street, Syracuse, KS.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $79 (1147%)
Insurance Median: $71 (1030%)
Cash: $79 (1147% of Medicare)
Ins. Median: $71 (1030% of 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 1030% of the Medicare baseline (a markup of 930%). 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
Blue Cross Blue Shield $13 - $28 189%
First Health Coventry - All Plans $67 972%
Cigna $75 1089%
UnitedHealthcare $75 1089%
Va Ccn - All Plans $79 1147%
Aetna $134 1945%

Consumer Guidance & Cost Commentary

For this blood test procedure, Hamilton County Hospital in Syracuse, KS, lists a cash price of $79.00, which matches the facility's negotiated rate with several major payers including Blue Cross Blue Shield, Cigna, and UnitedHealthcare. While the median amount paid by insurance members is $71.00, the cash price remains the lowest option available for this service. It is important to note that for patients with high-deductible plans, paying the cash price of $79.00 upfront may be more cost-effective than relying on insurance, as the insurer's negotiated rate of $71.00 often exceeds the cash price, and the patient would still be responsible for meeting their deductible before that lower amount is applied.

When evaluating the value of this service, it is helpful to compare rates against federal benchmarks rather than the hospital's full list price. The Medicare benchmark for this code is $6.89, which serves as a scientifically validated baseline for the true cost of delivery. Although the cash price of $79.00 is significantly higher than the Medicare rate, it aligns with the negotiated rates of many commercial insurers, suggesting that the facility is not charging the full chargemaster gross price to insured members. Patients should verify their specific plan details and ask the hospital directly about any "self-pay" or "prompt-pay" discounts that could further reduce the final amount owed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 North Huser Street, Syracuse, KS 67878
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals