Blood test, amylase
Facility: Decatur Health
Billing Code: 82150 (CPT)
- CPT Billing Code: 82150
- Insurance Median: $35
- Cash Discount Price: $42
- vs. Medicare Baseline: 5.40x 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 $6.48 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 540% of the Medicare baseline (a markup of 440%). 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $28 | 432% |
| UnitedHealthcare | $28 - $35 | 432% |
| Humana | $29 | 448% |
| Blue Cross Blue Shield | $32 | 494% |
| Aetna | $42 - $46 | 648% |
| Midlands Choice- All Plans | $42 | 648% |
| Medicaid / KanCare | $47 | 725% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Decatur Health in Oberlin, Kansas, the facility's cash price of $42.00 is slightly higher than the state average of $42.00 and the county average of $42.00. While commercial insurance plans negotiate rates ranging from $28 to $47 depending on the carrier, these negotiated amounts often exceed the cash price. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash rate directly can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the negotiated rate surpasses the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed.
The Medicare benchmark for this service is $6.48, which serves as a scientifically validated baseline for evaluating pricing markups. The facility's cash rate of $42.00 represents a significant markup relative to this federal standard, illustrating the difference between the true cost of care and commercial pricing structures. Patients should be aware that commercial negotiated rates frequently average 200% to 300% of Medicare amounts, whereas fair pricing is typically defined as 120% to 150% of the Medicare rate. To ensure transparency, consumers should request an itemized billing audit before paying any bill, as over 80% of hospital invoices contain errors such as double-billing or unbundled codes that can be disputed to reduce medical debt.