CMS Price Transparency Data

Blood test, lipase

Facility: The Children's Mercy Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $53
Cash Discount Price: $39
vs. Medicare Baseline: 7.69x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at The Children's Mercy Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 7.69x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)

Cash / Self-Pay: $39 (566%)

Insurance Median: $53 (769%)

Cash: $39 (566% of Medicare)

Ins. Median: $53 (769% of 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.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$7 - $55	102%
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%
Health Midwest Comprehensive Care	$53	769%
Nebraska Furniture Mart	$53	769%
Orscheln	$53	769%
Quiktrip	$53	769%
Wellfit/Centrus	$53	769%
Wppa Providrs Care	$53	769%
Humana	$54 - $55	784%
Coventry Health Care Of Kansas	$60 - $61	871%
Coxhealth Network	$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%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $39.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83690.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Children's Mercy Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83690.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.