Blood test, lipase
Facility: Hodgeman County Health Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $55
- Cash Discount Price: $62
- vs. Medicare Baseline: 7.98x 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 798% of the Medicare baseline (a markup of 698%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $26 - $28 | 377% |
| UnitedHealthcare | $50 - $74 | 726% |
| Triwest - All Plans | $50 | 726% |
| Humana | $50 | 726% |
| Medicaid / KanCare | $50 - $78 | 726% |
| Aetna | $62 | 900% |
| First Health - All Plans | $70 | 1016% |
| Wppa (Provdrscare) - All Plans | $74 | 1074% |
| Health Partners - All Plans | $74 | 1074% |
Consumer Guidance & Cost Commentary
For this blood test procedure at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash median price is $62.00, which is notably lower than the state average of $78.00. While most commercial insurance plans negotiate rates ranging from $50 to $78, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details. Additionally, because the facility is a Critical Access Hospital owned by the local government, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can sometimes bypass administrative fees and reduce the final cost.
The Medicare benchmark for this service is $6.89, which serves as a baseline for evaluating the facility's pricing markup. Although the commercial negotiated rates are significantly higher than the Medicare amount, this is typical for commercial contracts that include administrative overhead and risk adjustments. To ensure accuracy, patients should request a full itemized bill rather than accepting a summary invoice, as hospitals may obscure individual charges or unbundled codes. If a patient receives a bill that seems inconsistent with the data, they should dispute any errors in writing to the billing supervisor, as over 80% of hospital bills contain mistakes that can be corrected. Always confirm your deductible status before using insurance, as paying the negotiated rate without meeting your deductible threshold may result in higher out-of-pocket expenses than paying the cash price directly.