CMS Price Transparency Data

Blood test, lipase

Facility: Stanton County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $104
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 15.09x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Stanton County Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.09x the Medicare baseline. Located in 404 N Chestnut, Johnson, KS.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $77 (1118%)
Insurance Median: $104 (1509%)
Cash: $77 (1118% of Medicare)
Ins. Median: $104 (1509% 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 1509% of the Medicare baseline (a markup of 1409%). 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
Blue Cross Blue Shield $26 - $230 377%
Healthy Blue Mcr Adv - All Other Plans $103 - $238 1495%
Healthy Blue Mcaid $105 - $207 1524%

Consumer Guidance & Cost Commentary

For this blood test procedure at Stanton County Hospital, the cash price is $77.00, which is significantly lower than the facility's gross charge of $77.00 and the Medicare benchmark of $6.89. While the cash rate is higher than the Medicare amount, it is important to note that commercial insurance negotiated rates for this service range from $103.00 to $238.00 across three payers, meaning paying out-of-pocket could save you money if your insurance deductible is not yet met. Patients should verify their specific plan's deductible status before scheduling, as using insurance for shoppable tests can result in higher out-of-pocket costs if the negotiated rate exceeds the cash price. Additionally, you should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.

If you choose to use insurance, be aware that the allowed amounts vary by carrier, with Blue Cross Blue Shield plans seeing a low of $26.00 and Healthy Blue plans ranging from $103.00 to $238.00. Since this facility is an in-network Critical Access Hospital in Johnson, KS, the No Surprises Act protects you from balance billing for emergency care and non-emergency services from out-of-network providers at this location. However, if you receive a bill for a service not covered by federal protections, such as an unexpected ancillary charge, you should dispute the bill in writing with the insurer rather than paying immediately to avoid credit damage. Always request a full itemized CPT-coded bill before paying, as summary bills may hide

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 404 N Chestnut, Johnson, KS 67855
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals