Blood test, lipase
Facility: Clara Barton Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $78
- Cash Discount Price: $81
- vs. Medicare Baseline: 11.32x 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 1132% of the Medicare baseline (a markup of 1032%). 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% |
| 6 Degrees Health - All Plans | $60 - $102 | 871% |
| Wppa-All Plans | $68 - $116 | 987% |
| UnitedHealthcare | $76 - $130 | 1103% |
| Aetna | $76 - $130 | 1103% |
| Phcs - All Plans | $76 - $130 | 1103% |
| Hlth Partners Of Ks-All Plans | $78 - $133 | 1132% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at Clara Barton Hospital in Hoisington, KS, the cash median price is $81.00, which is lower than the negotiated rates paid by major payers ranging from $60 to $130. While the facility's cash rate is $11.30 higher than the national Medicare benchmark of $6.89, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated rates for insurers like UnitedHealthcare and Aetna can exceed the cash price. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the cash median of $81.00 remains a key reference point; however, patients should verify if their specific insurance plan has a lower allowed amount before scheduling to ensure they are not paying more out-of-pocket than necessary.
To maximize savings, consumers should proactively request a "prompt-pay" discount, which typically offers a 20% to 50% reduction for upfront payment within 30 days, bypassing the administrative costs associated with insurance claims processing. Before check-in, patients must explicitly ask for a self-pay classification and sign a waiver of insurance submission to prevent the hospital from automatically submitting a claim that would void the cash discount. Additionally, if a balance bill arises from out-of-network ancillary services, patients should dispute the amount using the No Surprises Act protections rather than paying immediately, and always demand a full itemized CPT-coded bill to identify any unbundled charges or services not rendered before finalizing payment.