Blood test, lipase
Facility: Stafford County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $46
- Cash Discount Price: $49
- vs. Medicare Baseline: 6.68x 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 668% of the Medicare baseline (a markup of 568%). 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 |
|---|---|---|
| UnitedHealthcare | $3 | 44% |
| Va Ccn-All Plans | $3 | 44% |
| Health Partners-All Plans | $46 | 668% |
| Medica Mcr- All Plans | $49 | 711% |
| Humana | $49 | 711% |
Consumer Guidance & Cost Commentary
For the blood test, lipase (CPT 83690) at Stafford County Hospital, the cash price is $49.00, which matches the facility's negotiated rate and the median paid amount. This rate is significantly lower than the Medicare benchmark of $6.89, reflecting a 6.7% markup relative to the federal standard. While the facility is a Critical Access Hospital in Stafford, KS, the data does not provide specific county or state average comparisons for this procedure, so patients should rely on the Medicare rate as the primary objective baseline for evaluating pricing fairness.
Patients should consider that paying cash upfront may result in lower out-of-pocket costs compared to using insurance, as commercial negotiated rates often include administrative overhead that inflates the baseline price. Since the cash price here equals the negotiated rate, there is no additional discount available through prompt-pay programs for this specific service, but it is always advisable to confirm self-pay or prompt-pay options directly with the hospital before scheduling. Additionally, because the facility is government-owned, billing practices may differ from private entities, and patients should request an itemized bill to ensure no errors or unbundled charges are included before finalizing payment.