Blood test, lipase
Facility: Wilson Medical Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $28
- Cash Discount Price: $25
- 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 - $60 | 58% |
| Tricare | $4 - $32 | 58% |
| UnitedHealthcare | $4 - $56 | 58% |
| Humana | $4 - $32 | 58% |
| Ambetter / Centene | $4 - $60 | 58% |
| Mulitplan-All Plans | $6 - $55 | 87% |
| Health Partners-All Plans | $6 - $55 | 87% |
| Cigna | $6 - $48 | 87% |
| Blue Cross Blue Shield | $7 - $60 | 102% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Wilson Medical Center in Neodesha, KS, the cash median price is $25.00, which is lower than the facility's negotiated rates of $28.00 and the median paid amount of $31.0. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rates exceed the cash price. It is important to note that commercial insurance carriers often pay significantly higher amounts than cash due to administrative processing costs and contract dynamics, meaning the lowest price listed here represents the self-pay option rather than the standard insurance reimbursement.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices can obscure individual line items and potential errors. If you receive a balance bill for out-of-network services, remember that the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce your final bill by 20% to 50% if you settle the account upfront, effectively bypassing the higher administrative fees associated with insurance claims.