Blood test, lipase
Facility: Sheridan County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $38
- Cash Discount Price: $59
- vs. Medicare Baseline: 5.52x 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 552% of the Medicare baseline (a markup of 452%). 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 |
|---|---|---|
| Celtic Insurance | $36 | 522% |
| Blue Cross Blue Shield | $38 | 552% |
| UnitedHealthcare | $56 | 813% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Sheridan County Hospital in Hoxie, KS, the cash price is $59.00, which matches the facility's median negotiated rate of $38.00 and the state average. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial insurance plans often pay significantly more than the cash price; for example, UnitedHealthcare's negotiated rate is $56.00, while Celtic Insurance and Blue Cross Blue Shield pay $36.00 and $38.00 respectively. If you have a high-deductible plan or have not yet met your deductible, paying the $59.00 cash price upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs once your deductible is exhausted.
To ensure you are not overcharged, it is important to request a full itemized bill before paying, as summary bills can obscure individual charges or include unbundled codes that should be combined. Additionally, if you receive a balance bill for services rendered at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Finally, ask the billing department about prompt-pay discounts, which can reduce the total amount owed by 20% to 50% if you settle the account in full within 30 days, bypassing the administrative costs associated with insurance claims processing.