Blood test, lipase
Facility: Stevens County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $28
- Cash Discount Price: $65
- vs. Medicare Baseline: 4.06x 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 406% of the Medicare baseline (a markup of 306%). 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 |
|---|---|---|
| Aetna | $4 - $65 | 58% |
| Humana | $24 | 348% |
| Blue Cross Blue Shield | $26 - $28 | 377% |
| First Health - All Plans | $58 | 842% |
| Wppa - All Plans | $62 | 900% |
| Medicaid / KanCare | $65 | 943% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Stevens County Hospital in Hugoton, Kansas, the facility's cash price of $65.00 matches the gross charge and the cash median. This rate is significantly higher than the Medicare benchmark of $6.89, which serves as the federal baseline for "true" cost. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for commercial payers range from $24 to $65, with a median negotiated amount of $28.00. It is important to note that for patients with high-deductible plans, paying the cash price of $65.00 upfront may be more cost-effective than using insurance, as the insurer's allowed amount often exceeds the cash rate due to administrative overheads embedded in the contract.
Patients should be aware that the facility's negotiated rates do not necessarily represent the lowest possible price available in the region, as in-network billing structures can vary widely. To minimize costs, individuals should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full before or shortly after the service. Additionally, because over 80% of hospital bills contain errors, it is advisable to request a detailed, itemized statement rather than accepting a summary bill. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may provide legal protections against paying the difference between the provider's full rate and the insurance allowed amount.