Blood test, lipase
Facility: Kiowa County Memorial Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $62
- Cash Discount Price: $60
- vs. Medicare Baseline: 9.00x 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 900% of the Medicare baseline (a markup of 800%). 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 - $62 | 406% |
| UnitedHealthcare | $56 - $70 | 813% |
| Aetna | $62 | 900% |
| Medica Prime Mcare Cost-All Plans | $62 | 900% |
| Celtic Comml Exchange-All Other Plans | $62 | 900% |
| Health Partners Of Ks-All Plans | $62 | 900% |
| Humana | $62 | 900% |
| Medicaid / KanCare | $70 | 1016% |
| Providrs Care/Wppa-All Plans | $105 | 1524% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at Kiowa County Memorial Hospital in Greensburg, KS, the facility's cash median price is $60.00, which is lower than the state average of $62.00. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $28 to $70, patients should be aware that cash payments can sometimes be more cost-effective if their insurance allows a higher negotiated rate than the cash price. Because this facility is a Critical Access Hospital owned by the local government, it may offer specific self-pay or prompt-pay discounts; patients are encouraged to ask about these upfront before scheduling to ensure they are not charged the full negotiated amount.
When reviewing your final bill, it is important to distinguish between the facility's gross charge of $70.00 and the actual amounts paid by insurers, which vary significantly by plan. If you receive a bill that includes charges higher than the negotiated rates, you may be facing balance billing, which is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act. To avoid unexpected costs, always request a detailed, itemized bill that lists specific CPT codes rather than accepting a summary invoice. Comparing the facility's Medicare benchmark rate of $6.89 to your commercial rates reveals the markup, and since fair pricing is typically 120% to 150% of Medicare, you can verify if the negotiated rates align with standard industry benchmarks.