CMS Price Transparency Data

Blood test, lipase

Facility: Mitchell County Hospital Health Systems

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $103
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 14.95x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mitchell County Hospital Health Systems is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 14.95x the Medicare baseline. Located in 400 W 8Th Street, P O Box 399, Beloit, KS.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $97 (1408%)
Insurance Median: $103 (1495%)
Cash: $97 (1408% of Medicare)
Ins. Median: $103 (1495% 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 1495% of the Medicare baseline (a markup of 1395%). 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
UnitedHealthcare $7 - $108 102%
Blue Cross Blue Shield $28 406%
Triwest Well Mark All Plans $92 1335%
Pref Hlth Care Sytms Comm - All Plans $97 1408%
First Health-All Plans $97 1408%
Aetna $97 1408%
Phc Leased Ntwrk Access - All Plans $103 1495%
Auxiant-All Plans $103 1495%
Multiplan Ppo - All Plans $103 1495%
Cigna $107 1553%
Health Partners Ks-All Plans $107 1553%

Consumer Guidance & Cost Commentary

For the CPT code 83690 (Blood test, lipase) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash median price is $97.00, which aligns closely with the state average of $97.00. While the hospital's gross chargemaster lists the service at $108.00, commercial insurance negotiated rates vary significantly, ranging from $7.00 to $108.00 across 11 different payers. Notably, several major insurers, including UnitedHealthcare, Blue Cross Blue Shield, and Triwest Well Mark All Plans, have negotiated rates that exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly rather than relying on insurance reimbursement.

To ensure you receive the most accurate pricing, it is important to understand that commercial rates are often inflated by administrative costs and contract structures, sometimes reaching 200% to 300% of the Medicare benchmark rate of $6.89 for this service. Before scheduling, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final cost by 20% to 50% if paid upfront. Additionally, if you are using insurance, be aware that summary bills may obscure individual charges; always request a full itemized audit to verify that no unbundled codes or services not rendered have been included in your final invoice.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 W 8Th Street, P O Box 399, Beloit, KS 67420
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals