Blood test, lipase
Facility: Cloud County Health Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $110
- Cash Discount Price: $81
- vs. Medicare Baseline: 15.97x 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 1597% of the Medicare baseline (a markup of 1497%). 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 | $104 - $108 | 1509% |
| Health Partners - All Plans | $110 | 1597% |
| Pponext-All Plans | $110 | 1597% |
| Mpi-All Plans | $110 | 1597% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Cloud County Health Center in Concordia, KS, the facility's negotiated rates for in-network insurance range from $104 to $110, which aligns closely with the median negotiated amount of $110. While the facility's cash price is lower at $81, patients with high-deductible plans should consider that paying cash upfront might save money if their insurance negotiated rate exceeds this amount, as commercial rates often include administrative overhead that pushes them higher than the cash price. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly by carrier, and you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts that could further reduce the final cost.
When evaluating the cost of this service, it is helpful to compare the facility's pricing against the Medicare benchmark, which stands at $6.89 for this code. The facility's cash rate of $81 represents a significant markup over the federal baseline, a common characteristic of commercial billing structures where rates can average 200% to 300% of Medicare. To ensure you are receiving fair pricing, request a detailed, itemized bill that breaks down every CPT code and charge, as summary bills often obscure errors or unbundled services. If you receive a balance bill for the difference between the provider's charge and your insurance payment, you may be entitled to protections under the No Surprises Act, particularly if the service was rendered at an in-network facility by an out-of-network provider.