Blood test, lipase
Facility: St Luke Hospital & Living Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $48
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 6.97x 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 697% of the Medicare baseline (a markup of 597%). 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 |
|---|---|---|
| Va Ccn | $48 | 697% |
| Kansas Department Of Health And Environment | $48 | 697% |
| Ambetter / Centene | $48 | 697% |
| UnitedHealthcare | $48 | 697% |
| Blue Cross Blue Shield | $48 | 697% |
| Humana | $48 | 697% |
| Bluestem Pace | $48 | 697% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate of $48.00 is identical to the lowest and highest amounts reported across seven payers, including UnitedHealthcare, Humana, and Blue Cross Blue Shield. This rate represents a 7.0% increase compared to the Medicare benchmark of $6.89, which serves as the federal baseline for healthcare costs. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific cash or median paid amount for this service. However, patients with high-deductible plans should note that if their insurance negotiated rate exceeds the facility's cash price, paying out-of-pocket for self-pay or prompt-pay discounts could potentially result in lower total costs. It is essential to contact the hospital directly to confirm available self-pay rates and request any prompt-pay discounts before scheduling.
Because this service is covered by multiple insurance plans, patients should be aware of the risks associated with balance billing if they receive care from out-of-network providers or ancillary services not included in the main contract. Although the No Surprises Act protects patients from balance billing for emergency and non-emergency services at in-network facilities, unexpected charges can still occur if specific lab components are billed separately by out-of-network entities. To avoid surprise costs, patients should request a full itemized bill before paying and verify that all charges are bundled correctly rather than accepting summary invoices. If any discrepancies appear, such as unbundled codes or services not rendered, patients should dispute the bill in writing to ensure they are only paying for the actual care received.