Blood test, lipase
Facility: Clay County Medical Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $59
- Cash Discount Price: $62
- vs. Medicare Baseline: 8.56x 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 856% of the Medicare baseline (a markup of 756%). 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 | $58 | 842% |
| Aetna | $58 | 842% |
| Multiplan- All Plans | $59 | 856% |
| UnitedHealthcare | $59 | 856% |
| Health Partners - All Plans | $59 | 856% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Clay County Medical Center in Clay Center, KS, the cash median price is $62.00, which matches the facility's gross charge. This rate is significantly higher than the state average of $58.00, representing an 8.6% increase over the typical state cost. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that paying cash directly can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling your visit.
When using insurance, the negotiated rates for this service range from $58.00 to $59.00 across five payers, including Wppa/Providrs Care, Aetna, Multiplan, UnitedHealthcare, and Health Partners. These negotiated amounts are slightly lower than the cash price but may still result in higher out-of-pocket costs if your personal deductible has not yet been met. Because commercial rates often include administrative overhead and contract markups, it is important to verify your specific plan's allowed amount before the procedure. If you choose to pay out-of-network or encounter unexpected charges, remember that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, and you should always request a detailed, itemized bill to ensure accuracy.