Blood test, lipase
Facility: Medicine Lodge Memorial Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $35
- Cash Discount Price: $37
- vs. Medicare Baseline: 5.08x 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 508% of the Medicare baseline (a markup of 408%). 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 |
|---|---|---|
| Tricare | $29 | 421% |
| Humana | $33 | 479% |
| Aetna | $34 - $37 | 493% |
| Hpk-All Plans | $35 | 508% |
| UnitedHealthcare | $35 | 508% |
| Medicaid / KanCare | $37 | 537% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the facility's cash price of $37.00 is identical to the state average and significantly lower than the Medicare benchmark of $6.89. While the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates for major payers like Aetna and UnitedHealthcare range from $34.00 to $37.00, which are higher than the cash price. This pricing structure suggests that for patients with high-deductible plans, paying the cash price of $37.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. Patients should verify their specific plan's deductible status before scheduling, as paying the negotiated rate without meeting the deductible could result in out-of-pocket costs similar to or higher than the cash price.
To ensure you are not overcharged, it is crucial to request an itemized bill before finalizing payment, as summary bills often obscure individual service costs. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their statement line-by-line to confirm no unbundled codes or services not rendered are included. Additionally, since the facility offers a cash price equal to the state average, patients should explicitly ask about "self-pay" or "prompt-pay" discounts at registration, which can further reduce the total cost by bypassing administrative fees associated with insurance claims processing.