CMS Price Transparency Data

Blood test, lipase

Facility: Pawhuska Hospital, Inc

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $31
Cash Discount Price: $24
vs. Medicare Baseline: 4.50x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Pawhuska Hospital, Inc is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 4.50x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$24

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $24 (348%)

Insurance Median: $31 (450%)

Cash: $24 (348% of Medicare)

Ins. Median: $31 (450% 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 450% of the Medicare baseline (a markup of 350%). 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	$3 - $30	44%
Healthchoice Ip/Op Only - All Plans	$11	160%
Community Care Comm - All Plans	$17	247%
Blue Cross Blue Shield	$22 - $36	319%
Aetna	$24 - $42	348%
Tricare	$24	348%
Wellcare Mcr Adv - All Plans	$24	348%
Humana	$25 - $42	363%
Healthcare Highways - All Plans	$27	392%
Cigna	$29	421%
Multiplan - All Plans	$32	464%
Ambetter / Centene	$37	537%
Preferred Commchoice Ip/Op Only - All Plans	$38	552%
Soonerselect Mcaid - All Plans	$42	610%

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 $24.
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 Pawhuska Hospital, Inc 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.