Blood test, lipase
Facility: Scott County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $87
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 12.63x 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 1263% of the Medicare baseline (a markup of 1163%). 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 |
|---|---|---|
| UnitedHealthcare | $7 - $92 | 102% |
| Blue Cross Blue Shield | $28 | 406% |
| Humana | $41 | 595% |
| Wppa | $58 - $1,200 | 842% |
| Aetna | $87 | 1263% |
Consumer Guidance & Cost Commentary
For this blood test, lipase (CPT 83690) at Scott County Hospital, the facility's negotiated rates range from $7 to $1,200 across five payers, with a median negotiated amount of $87.00. While the facility is a Critical Access Hospital in Scott City, KS, the data does not provide specific county or state average figures for comparison. However, it is important to note that cash-pay rates are not listed for this service. Patients with high-deductible plans should be aware that paying out-of-pocket can sometimes be cheaper if the insurance negotiated rate exceeds the cash price, though in this specific case, no cash price is available to make that comparison.
The Medicare benchmark for this procedure is $6.89, and the facility's negotiated rates are significantly higher, reflecting the standard administrative load and contract dynamics of commercial insurance. The No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but patients should still request a full itemized bill to verify that no unbundled codes or services not rendered are included. If you are self-paying, ask the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid upfront, as these discounts bypass the costly claims processing cycle that inflates insurance rates.