Blood test, lipase
Facility: Graham County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $28
- Cash Discount Price: $38
- vs. Medicare Baseline: 4.06x 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 406% of the Medicare baseline (a markup of 306%). 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 - $36 | 44% |
| Medicaid / KanCare | $11 | 160% |
| Medicare (plans) | $28 | 406% |
| Blue Cross Blue Shield | $28 | 406% |
| Celtic Commercial-All Other Plans | $31 | 450% |
| Wppa (Providers Care)-All Plans | $36 | 522% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at Graham County Hospital in Hill City, Kansas, the cash price is $38.00, which matches the facility's median negotiated rate and the state average. This service is covered by six payers, with negotiated rates ranging from $11 to $36 depending on the plan. While Medicare reimburses $6.89 for this code, commercial payers negotiate rates that are generally higher than the Medicare benchmark, reflecting the administrative costs and contract dynamics of in-network agreements. Patients with high-deductible plans may find that paying the cash price of $38.00 upfront is more cost-effective than having insurance process the claim, as the negotiated allowed amount could exceed the cash rate.
To ensure you are receiving the best possible price, it is important to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these can reduce the final bill by 20% to 50%. If you choose to use insurance, be aware that balance billing is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services like lab tests are out-of-network. If you receive a bill, always request a full itemized statement to verify that all charges are accurate and that no services were unbundled or double-billed, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.