Blood test, lipase
Facility: Memorial Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $64
- Cash Discount Price: $116
- vs. Medicare Baseline: 9.29x 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 929% of the Medicare baseline (a markup of 829%). 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 | $20 | 290% |
| Humana | $58 | 842% |
| Tricare | $58 | 842% |
| Medicare (plans) | $59 | 856% |
| Ambetter / Centene | $64 | 929% |
| Coventry - All Other Plans | $104 | 1509% |
| Health Partners Of Kansas - All Plans | $110 | 1597% |
| Preferred Healthcare-All Plans | $110 | 1597% |
| Wppa/Providers Care-All Plans | $162 | 2351% |
Consumer Guidance & Cost Commentary
For this blood test service at Memorial Hospital in Abilene, KS, the cash price is $116.00, which matches the facility's median paid amount. While the hospital is a Critical Access Hospital owned by the Government - Hospital District or Authority, patients with high-deductible plans might find paying cash directly cheaper than using insurance, as the negotiated rates for in-network payers like Blue Cross Blue Shield and Humana range from $20 to $58, yet the cash price remains the same. It is important to note that commercial negotiated rates often include administrative overhead and can sometimes exceed the cash price; therefore, patients should always ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are getting the best possible rate.
When comparing this service to broader benchmarks, the facility's cash rate of $116.00 is significantly higher than the Medicare amount of $6.89, reflecting the standard markup found in commercial pricing where negotiated rates often average 200% to 300% of Medicare. If a patient receives care from an out-of-network provider, they could face balance billing for the difference between the full chargemaster rate and what their insurance allows, though the No Surprises Act provides federal protections against such surprise bills for emergency and non-emergency services at in-network facilities. To avoid unexpected costs, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed in writing to reduce medical debt.