Blood test, lipase
Facility: Susan B Allen Memorial Hospital
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $554
- Cash Discount Price: $35
- vs. Medicare Baseline: 80.41x 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 8041% of the Medicare baseline (a markup of 7941%). 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 | $350 | 5080% |
| Providrs Care | $757 | 10987% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $35.00, which is significantly lower than the negotiated rates of $350 and $757 charged by UnitedHealthcare and Providrs Care, respectively. While the facility's cash price is lower than the state average, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds this amount. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price, so comparing directly to the Medicare amount of $6.89 reveals the true cost structure.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, unexpected ancillary charges can still occur if specific lab components are billed separately. To minimize costs, consumers should request a full itemized billing audit before paying, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, asking for a prompt-pay discount at the time of scheduling can bypass costly insurance claims processing and reduce the final bill by 20% to 50%, ensuring you receive the most accurate and transparent pricing available.