Blood test, lipase
Facility: Kiowa District Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $52
- Cash Discount Price: $44
- 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 |
|---|---|---|
| Healthchoice-All Plans | $10 | 145% |
| Tricare | $21 | 305% |
| Blue Cross Blue Shield | $28 | 406% |
| UnitedHealthcare | $44 - $55 | 639% |
| Health Partners Of Ks-All Plans | $48 | 697% |
| Humana | $50 | 726% |
| Multiplan-All Plans | $52 | 755% |
| Triwest-All Plans | $52 | 755% |
| Gbs Insurance - All Plans | $52 | 755% |
| Medicare (plans) | $52 | 755% |
| Aetna | $52 | 755% |
| Medicaid / KanCare | $55 | 798% |
| Providers Care (Wppa)-All Plans | $82 | 1190% |
| Liberty Healthshare-All Plans | $89 | 1292% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Kiowa District Hospital, the facility's cash median price is $44.00, which is lower than the state average of $52.00. While the facility's negotiated rates with most payers align with the state median of $52.00, some commercial plans like UnitedHealthcare have a range extending up to $55.00. Given that the cash price is $7.50 lower than the Medicare benchmark of $6.89 (adjusted for local factors), patients with high-deductible plans or those without insurance may find paying the cash rate directly more cost-effective than relying on insurance, which often incurs higher administrative costs. It is important to note that while the facility is a Critical Access Hospital in Kiowa, KS, and owned by a Government Hospital District, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing the standard insurance billing cycle.
The data indicates that the facility's negotiated rates are generally consistent with the state average, with the lowest rate among payers being $10.00 and the highest reaching $89.00 for specific plans like Liberty Healthshare. However, since the cash price of $44.00 is significantly below the median paid amount of $52.00, consumers should be aware that insurance claims often result in higher out-of-pocket costs due to the inclusion of administrative processing fees and potential deductibles. To ensure transparency, patients should demand a full itemized bill rather than accepting a summary invoice, as this