Blood test, lipase
Facility: Logan County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $52
- Cash Discount Price: $15
- vs. Medicare Baseline: 7.55x 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 755% of the Medicare baseline (a markup of 655%). 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 | $28 | 406% |
| Humana | $32 | 464% |
| Health Partners - All Plans | $71 | 1030% |
| Medicaid / KanCare | $75 | 1089% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the facility's cash price of $15.00 is significantly lower than the state average of $75.00 and the county average of $75.00. While the median negotiated rate for in-network insurance plans is $52.00, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds this figure. It is important to note that commercial negotiated rates often include administrative overhead and can be higher than cash prices due to multi-layered billing structures. To potentially lower costs further, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
When using insurance, patients should be aware that the No Surprises Act protects them from balance billing for out-of-network services at in-network facilities, though unexpected ancillary charges can still occur. If a bill is received, it is critical to request a full itemized CPT-coded statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing the facility's rates to the Medicare benchmark of $6.89 reveals that the commercial negotiated rate of $52.00 represents a substantial markup, highlighting the value of understanding the difference between the facility's gross charges and the actual reimbursement rates.