CMS Price Transparency Data

Blood test, lipase

Facility: Great Plains Of Sabetha

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $43
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 6.24x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Great Plains Of Sabetha is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.24x the Medicare baseline. Located in 603 S 14Th Street, Sabetha, KS.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $45 (653%)
Insurance Median: $43 (624%)
Cash: $45 (653% of Medicare)
Ins. Median: $43 (624% of 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 624% of the Medicare baseline (a markup of 524%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Celtic Mcr Adv $23 334%
Aetna $24 - $45 348%
Celtic Comm Exchange-All Other Plans $29 421%
Great West Healthcare-All Plans $38 552%
UnitedHealthcare $42 - $45 610%
Century/Wppa/Providers-All Plans $43 624%
Federated Mutual Ins-All Plans $43 624%
Humana $43 624%
Multiplan-Phcs-All Plans $43 624%
Cigna $43 624%
Medicaid / KanCare $45 653%
Blue Cross Blue Shield $45 653%

Consumer Guidance & Cost Commentary

For the blood test code 83690 at Great Plains Of Sabetha in Sabetha, Kansas, the facility's cash median rate is $45.00, which matches the gross charge listed. This cash price is notably higher than the state average for this service, which is $38.00. While the facility's negotiated rates with insurance payers range from $23.00 to $45.00, patients should be aware that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. In cases where a patient has a high deductible or is self-pay, paying the cash price of $45.00 upfront can be more cost-effective than relying on insurance, which may result in higher allowed amounts before deductibles are met.

Patients are encouraged to verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. It is important to compare these facility-specific rates against the broader context of the region; for instance, the facility's cash rate is higher than the state median, but some insurance payers negotiate rates as low as $23.00, which is significantly below the cash price. To ensure you are receiving the best possible price, always request an itemized bill before paying and avoid accepting summary invoices that may hide errors or unbundled charges.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 603 S 14Th Street, Sabetha, KS 66534
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals