Blood test, lipase
Facility: Morris County Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $55
- Cash Discount Price: $84
- vs. Medicare Baseline: 7.98x 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 798% of the Medicare baseline (a markup of 698%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $7 | 102% |
| Va Ccn-All Plans | $10 | 145% |
| Aetna | $11 | 160% |
| Blue Cross Blue Shield | $26 - $55 | 377% |
| UnitedHealthcare | $55 - $140 | 798% |
| Choice Care Mcr Adv-All Plans | $55 | 798% |
| Coventry Mcr | $55 | 798% |
| Cigna | $101 | 1466% |
| Coventry Comm-All Other Plans | $126 | 1829% |
| Multiplan-All Plans | $126 | 1829% |
Consumer Guidance & Cost Commentary
For the blood test, lipase procedure (CPT 83690) at Morris County Hospital in Council Grove, KS, the cash price of $84.00 is significantly lower than the facility's gross charge of $140.00. While the median negotiated rate across ten payers is $55.00, this figure is still higher than the cash price, illustrating that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans who have not yet met their coverage thresholds. The facility, a Critical Access Hospital owned by the local government, lists a cash median of $84.00, which is notably higher than the state average of $8.00 when compared directly to the Medicare benchmark of $6.89. Patients should verify if their specific insurance plan allows for a lower allowed amount than the facility's negotiated rate, as the administrative costs embedded in commercial contracts often inflate the final bill beyond the actual cost of care.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their statement line-by-line to confirm that all charges are accurate and that no unnecessary ancillary services were billed. Additionally, since the facility offers a prompt-pay discount for upfront payment, you should contact the billing department prior to scheduling to confirm your eligibility for self-pay or prompt-pay rates, which can bypass the higher administrative fees associated with insurance claims processing. Always ensure you