Blood test, lipase
Facility: Wamego Health Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $7
- Cash Discount Price: $75
- vs. Medicare Baseline: 1.02x 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.
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 | $7 | 102% |
| Aetna | $7 | 102% |
| Providrs Care | $7 | 102% |
| Medicaid / KanCare | $7 | 102% |
| Blue Cross Blue Shield | $160 - $169 | 2322% |
Consumer Guidance & Cost Commentary
For the CPT code 83690 (Blood test, lipase) at Wamego Health Center in Wamego, KS, the cash median price is $75.00, which is significantly lower than the facility's gross charge of $188.00. While the facility is in-network for UnitedHealthcare, Aetna, Providrs Care, and Medicaid/KanCare, the negotiated rates for these payers range from $7.00 to $169.00 depending on the specific plan. Notably, the median negotiated rate across all payers is $7.00, which is lower than the cash price of $75.00. This suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, using insurance may result in lower out-of-pocket costs compared to paying cash directly, as the insurance allowed amount often caps the patient's responsibility below the cash-pay rate.
When evaluating the facility's pricing against broader benchmarks, the Medicare amount for this service is $6.89. The facility's cash price of $75.00 represents a markup of approximately 1,089% over the Medicare rate, while the median negotiated rate of $7.00 is only about 101% above the Medicare amount. This indicates that the negotiated rates offered by commercial insurers are much closer to the true cost of care established by Medicare than the cash price might initially suggest. Patients should be aware that while prompt-pay discounts can reduce bills by 20% to 50% for upfront payments, the existing negotiated rates are already competitive relative to the Medicare baseline. It