Blood test, lipase
Facility: Amberwell Atchison Association
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $39
- Cash Discount Price: $94
- vs. Medicare Baseline: 5.66x 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 566% of the Medicare baseline (a markup of 466%). 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 |
|---|---|---|
| Triwest - All Plans | $23 - $39 | 334% |
| Superior Select Mcr Adv - All Plans | $23 - $39 | 334% |
| UnitedHealthcare | $23 - $212 | 334% |
| Humana | $23 - $53 | 334% |
| Va Ccn - All Plans | $23 - $39 | 334% |
| Blue Cross Blue Shield | $26 - $28 | 377% |
| Ambetter / Centene | $35 - $60 | 508% |
| Aetna | $38 - $65 | 552% |
| Cigna | $38 - $65 | 552% |
| Oscar - All Plans | $52 - $88 | 755% |
| Centrus Health Direct - All Plans | $52 - $88 | 755% |
| Multiplan - All Plans | $54 - $92 | 784% |
| Wppa Providrs Care - All Plans | $62 - $106 | 900% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase), Amberwell Atchison Association lists a cash price of $94.00, which matches the facility's cash median. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $23 to $106, the cash price often represents a more transparent baseline for patients. It is important to note that commercial negotiated rates frequently exceed cash prices due to administrative overhead and contract structures; therefore, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, provided they verify their out-of-pocket maximums. Before scheduling, patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle.
This service is provided at a Critical Access Hospital in Atchison, KS, and the facility's pricing structure should be evaluated against the Medicare benchmark of $6.89. While the data does not provide specific state or county average comparisons for this exact code, the Medicare rate serves as the objective baseline for evaluating markup, as commercial rates often average 200% to 300% of this federal rate. If a patient receives a bill that exceeds the negotiated amount, they may be facing balance billing, which is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. To ensure accuracy, patients should request a full itemized bill to review specific CPT codes and avoid paying for services that were never rendered or unbund