Blood test, lipase
Facility: Smith County Memorial Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $42
- Cash Discount Price: $45
- vs. Medicare Baseline: 6.10x 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 610% of the Medicare baseline (a markup of 510%). 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 | $28 | 406% |
| Medicaid / KanCare | $32 - $45 | 464% |
| Multiplan-All Plans | $40 | 581% |
| Wppa-All Plans | $42 | 610% |
| Midlands Choice-All Plans | $43 | 624% |
| UnitedHealthcare | $43 | 624% |
| Health Partners Of Ks Ppo-All Plans | $43 | 624% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Smith County Memorial Hospital in Smith Center, KS, the cash price is $45.00, which matches the facility's median negotiated rate of $42.00 and the state average of $45.00. While the hospital's gross charge is $45.00, patients with high-deductible plans may find paying cash directly cheaper than using insurance, as the negotiated rate of $42.00 is lower than the cash price in this instance. However, if a patient's insurance allows a higher amount than the cash price, they should verify their specific plan's allowed amount before scheduling to avoid unexpected costs.
The facility's negotiated rates for this service range from $28.00 to $45.00 across seven payers, with the lowest rate of $28.00 offered by Blue Cross Blue Shield. When compared to the Medicare benchmark of $6.89, the commercial negotiated rates reflect standard market pricing for this procedure. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still advisable to request a self-pay or prompt-pay discount before check-in. If a patient receives an itemized bill, they should review it line-by-line to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.