CMS Price Transparency Data

Blood test, lipase

Facility: Osborne County Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $42
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 6.10x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Osborne County Memorial Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.10x the Medicare baseline. Located in 237 W Harrison Street Suite 100, Osborne, KS.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $39 (566%)
Insurance Median: $42 (610%)
Cash: $39 (566% of Medicare)
Ins. Median: $42 (610% 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 610% of the Medicare baseline (a markup of 510%). 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
UnitedHealthcare $35 508%
Health Partners Of Kansas $40 581%
Wppa $44 639%
Blue Cross Blue Shield $45 653%

Consumer Guidance & Cost Commentary

For this blood test for lipase at Osborne County Memorial Hospital, the cash price of $39.00 is notably lower than the facility's negotiated rates, which range from $35.00 to $45.00 depending on the insurance carrier. While the cash price is the lowest amount listed, it is important to note that for patients with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than using insurance, as the negotiated rates paid by insurers often exceed the cash rate. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative fees associated with insurance claims processing.

When evaluating the cost relative to federal standards, the Medicare benchmark for this service is $6.89, which serves as a scientifically validated baseline for the true cost of delivery. The cash price of $39.00 represents a significant markup over this Medicare rate, illustrating how commercial pricing structures can differ substantially from government benchmarks. Since the facility is a Critical Access Hospital in Osborne, KS, and is government-owned, patients should be aware that while the facility is in-network for the four listed payers, the specific allowed amounts vary. To ensure you are receiving the most accurate pricing, it is recommended to request a full itemized bill before payment to identify any potential errors or unbundled charges that could be disputed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 237 W Harrison Street Suite 100, Osborne, KS 67473
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals