Blood test, amylase
Facility: Ellsworth County Medical Center
Billing Code: 82150 (CPT)
- CPT Billing Code: 82150
- Insurance Median: $50
- Cash Discount Price: $56
- vs. Medicare Baseline: 7.72x 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 772% of the Medicare baseline (a markup of 672%). 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 | $24 - $25 | 370% |
| Va Ccn-All Plans | $26 | 401% |
| Triwest -All Plans | $26 | 401% |
| Humana | $26 - $53 | 401% |
| Healthy Blue Mcr Adv | $26 | 401% |
| UnitedHealthcare | $36 - $56 | 556% |
| Aetna | $50 | 772% |
| First Health - All Plans | $50 | 772% |
| Cigna | $53 | 818% |
| Healthy Blue Mcaid- All Other Plans | $56 | 864% |
| Medicaid / KanCare | $56 | 864% |
| Coventry Mcaid-All Plans | $56 | 864% |
| Providers Care-Wppa-All Plans | $84 | 1296% |
Consumer Guidance & Cost Commentary
For this blood test, the facility's cash price of $56.00 is significantly higher than the state average of $41.00, which is reflected in the median paid amount for this service. While commercial insurance plans negotiate rates that typically cap costs, the data shows a wide range of allowed amounts across payers, with Humana plans ranging from $26 to $53 and UnitedHealthcare from $36 to $56. Because the cash price is already above the state median, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective than relying on insurance, especially if their negotiated rate exceeds the cash price. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary considerably by carrier.
The facility, a Critical Access Hospital in Ellsworth, KS, has a facility rating of 2 and operates under proprietary ownership. While the Medicare benchmark for this procedure is $6.48, the commercial negotiated rates average $50.00, highlighting a substantial markup common in the healthcare system. Patients should be aware that balance billing is generally prohibited for in-network services under federal law, but unexpected charges can still occur if ancillary services are out-of-network. To avoid surprise costs, we recommend requesting a prompt-pay discount or self-pay rate before check-in and always demanding a full itemized bill to review every charge against the CPT code 82150.