CMS Price Transparency Data

Blood test, lipase

Facility: Norton County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $39
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Norton County Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.66x the Medicare baseline. Located in 102 E Holme Street, Norton, KS.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $69 (1001%)
Insurance Median: $39 (566%)
Cash: $69 (1001% of Medicare)
Ins. Median: $39 (566% 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 566% of the Medicare baseline (a markup of 466%). 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 $39 566%

Consumer Guidance & Cost Commentary

For this blood test procedure at Norton County Hospital, the cash price of $69.00 is significantly lower than the facility's negotiated rate of $39.00, which aligns exactly with the lowest and highest negotiated amounts reported for this service. This cash price also represents a substantial discount compared to the Medicare benchmark of $6.89, with the cash rate being 5.7 times higher than the federal baseline. While commercial insurance contracts often result in negotiated rates that exceed cash prices due to administrative overhead, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount is higher than $69.00. It is important to verify your specific plan's allowed amount before deciding between cash payment and insurance coverage.

To ensure you are not overcharged, always request a full itemized bill that lists every specific CPT code and unit cost rather than accepting a summary invoice that obscures individual charges. This audit helps identify errors such as unbundled services or charges for items that were never delivered, which can occur in over 80% of hospital bills. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you settle the account in full within 30 days. Since this facility is a Critical Access Hospital in Norton, KS, and is owned by the local government, you may also want to confirm if any self-pay discounts are available before scheduling your appointment.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Holme Street, Norton, KS 67654
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals