Blood test, lipase
Facility: Children'S Mercy South
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $53
- Cash Discount Price: $39
- vs. Medicare Baseline: 7.69x 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 769% of the Medicare baseline (a markup of 669%). 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 |
|---|---|---|
| UnitedHealthcare | $6 - $55 | 87% |
| Healthy Blue | $8 - $19 | 116% |
| Medicaid / KanCare | $8 | 116% |
| Home State Health | $17 | 247% |
| Blue Cross Blue Shield | $33 - $61 | 479% |
| Cigna | $39 - $57 | 566% |
| Medica | $47 - $48 | 682% |
| Aetna | $49 - $56 | 711% |
| Centivo | $53 | 769% |
| Nebraska Furniture Mart | $53 | 769% |
| Quiktrip | $53 | 769% |
| Wellfit/Centrus | $53 | 769% |
| Orscheln | $53 | 769% |
| Health Midwest Comprehensive Care | $53 | 769% |
| Wppa Providrs Care | $53 | 769% |
| Humana | $54 - $55 | 784% |
| Coxhealth Network | $60 - $61 | 871% |
| Coventry Health Care Of Kansas | $60 - $61 | 871% |
| Mercy Health | $61 - $62 | 885% |
| Multiplan | $62 | 900% |
| American Healthcare Alliance | $69 - $70 | 1001% |
| Healthlink | $71 - $72 | 1030% |
| National Preferred Provider Network | $73 - $74 | 1060% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Children's Mercy South in Overland Park, KS, the facility's cash median price is $39.00, which is significantly lower than the state average of $53.00. While many commercial payers have negotiated rates ranging from $6 to $74, the cash price remains the most affordable option for patients without insurance. This pricing structure highlights a common billing dynamic where paying out-of-pocket can result in substantial savings compared to the negotiated rates insurers charge, particularly for patients with high-deductible plans who may face higher out-of-pocket costs if their insurance does not cover the service or if the allowed amount exceeds the cash price.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency services at in-network facilities, it does not automatically eliminate all unexpected costs for non-emergency procedures or ancillary services like lab tests. To ensure you receive the best possible rate, it is advisable to explicitly request a "self-pay" or "prompt-pay" discount before scheduling your appointment, as these upfront payment incentives can further reduce the bill. If you do receive a bill, always demand a full itemized statement showing specific CPT codes rather than accepting a summary invoice, and consider disputing any charges that appear incorrect or unbundled to avoid unnecessary medical debt.