Blood test, lipase
Facility: Fredonia Regional Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $61
- Cash Discount Price: $68
- vs. Medicare Baseline: 8.85x 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 885% of the Medicare baseline (a markup of 785%). 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 | $5 - $61 | 73% |
| Blue Cross Blue Shield | $28 - $33 | 406% |
| Aetna | $34 - $61 | 493% |
| Veterans Programs - All Plans | $34 | 493% |
| Meritain-All Plans | $61 | 885% |
| Cigna | $61 | 885% |
| Reserve National-All Plans | $61 | 885% |
Consumer Guidance & Cost Commentary
For the CPT code 83690, representing a blood test for lipase, the cash price at Fredonia Regional Hospital is $68.00, which matches the facility's median negotiated rate of $61.00 and the state average of $68.00. While the facility is a Critical Access Hospital in Kansas with government-local ownership, patients should be aware that commercial insurance negotiated rates can sometimes exceed cash prices due to administrative overhead and contract structures. For individuals with high-deductible plans, paying the cash price of $68.00 upfront may result in lower out-of-pocket costs compared to the insurance allowed amount, which varies significantly across payers. It is important to verify your specific plan's deductible status and allowed amounts before scheduling to avoid unexpected charges.
To ensure you are receiving the most accurate pricing, always request a full itemized bill rather than accepting a summary invoice that obscures individual line items. This audit helps identify potential errors, unbundled codes, or services not rendered, which can account for over 80% of billing disputes. Additionally, if you are using insurance, remember that the No Surprises Act protects you from balance billing for out-of-network providers at in-network facilities, but you should still confirm your network status and ask about prompt-pay discounts before check-in. These discounts, typically ranging from 20% to 50%, can reduce your final bill if you pay in full within a short window, bypassing the costly claims processing cycle that often inflates commercial rates.