CMS Price Transparency Data

Blood test, lipase

Facility: Greenwood County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $67
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 9.72x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Greenwood County Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.72x the Medicare baseline. Located in 100 W 16Th Street, Eureka, KS.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $63 (914%)
Insurance Median: $67 (972%)
Cash: $63 (914% of Medicare)
Ins. Median: $67 (972% 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 972% of the Medicare baseline (a markup of 872%). 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
UnitedHealthcare $5 - $66 73%
Blue Cross Blue Shield $26 - $28 377%
Triwest - All Plans $28 406%
Choicecare Mcr Adv - All Plans $33 479%
Tricare $33 479%
Integrated Health Plan - All Plans $59 856%
Beech Street - All Plans $67 972%
First Health - All Other Plans $67 972%
First Health Ccn Network $67 972%
Preferred Hs (Coventry) - All Plans $71 1030%
Principal Health Care Inc - All Plans $75 1089%
Amerigroup Mcaid-All Plans $79 1147%
Medicaid / KanCare $79 1147%
Providrs Care/Wppa - All Plans $118 1713%

Consumer Guidance & Cost Commentary

For this blood test procedure at Greenwood County Hospital, the cash price of $63.00 is lower than the facility's negotiated rates, which range from $5 to $118 across 14 different insurance plans. While the median negotiated rate is $67.00, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the insurance allowed amount often exceeds the cash rate. It is important to note that while the facility is a Critical Access Hospital in Eureka, KS, with government-local ownership, the specific cash price of $63.00 does not appear to be explicitly compared to a statewide or countywide average in the provided data, so patients should verify local pricing benchmarks directly with the hospital or their insurer.

To avoid unexpected costs, patients should request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if a patient receives a bill from an out-of-network provider at this in-network facility, they may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services. If a bill is received, patients should demand a full itemized audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Disputing these errors in writing can significantly reduce medical debt, ensuring the final charge reflects only the actual services provided.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 W 16Th Street, Eureka, KS 67045
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals