CMS Price Transparency Data

Blood test, lipase

Facility: Minneola District Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $37
  • Cash Discount Price: $29
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Minneola District Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.37x the Medicare baseline. Located in 212 Main, Minneola, KS.
Cash / Self-Pay
$29

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $29 (421%)
Insurance Median: $37 (537%)
Cash: $29 (421% of Medicare)
Ins. Median: $37 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Va Community Care Program-All Plans $27 392%
Humana $27 392%
UnitedHealthcare $27 - $41 392%
Blue Cross Blue Shield $28 406%
Providrs Care Network-All Plans $35 508%
Corporate Plan Management-All Plans $35 508%
Triwest-All Plans $37 537%
Preferred Health Care (Coventry)-All Other Plans $37 537%
Health Partners Of Kansas-All Plans $39 566%
Phc (Coventry) Leased Network $39 566%
Aetna $39 - $41 566%
Medicaid / KanCare $41 595%

Consumer Guidance & Cost Commentary

For the blood test, lipase procedure (CPT 83690) at Minneola District Hospital, the cash price is $29.00, which is lower than the facility's negotiated rates ranging from $27.00 to $41.00 across twelve payers. While the cash price is the lowest amount a patient could pay, it is important to note that for patients with high-deductible plans, the insurance negotiated rate may actually be cheaper if the patient's deductible has not yet been met. The facility, a Critical Access Hospital in Kansas, does not offer a specific self-pay or prompt-pay discount in this dataset, so patients should verify current self-pay rates directly with the hospital before scheduling to ensure they are not paying the full negotiated amount.

When evaluating the cost, it is helpful to compare the facility's pricing against the Medicare benchmark, which stands at $6.89 for this service. The facility's cash price of $29.00 represents a 5.4x markup over the Medicare rate, which is significantly higher than the typical fair pricing range of 120% to 150% of Medicare. Because the facility is a government-owned hospital district, these rates are set by the authority rather than individual commercial contracts. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, they should still request an itemized bill to ensure no unbundled charges or services not rendered are included in the final invoice.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 212 Main, Minneola, KS 67865
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals