Blood test, lipase
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $138
- Cash Discount Price: $184
- vs. Medicare Baseline: 20.03x 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 2003% of the Medicare baseline (a markup of 1903%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $110 | 1597% |
| Americas Choice Provider Network | $129 | 1872% |
| Provider Network Of America | $138 | 2003% |
| Usa Managed Care Organization | $138 | 2003% |
| Velocity | $138 | 2003% |
| Quiktrip Corporation | $138 | 2003% |
| Multiplan-Phcs | $147 | 2134% |
| Prime Health Services | $156 | 2264% |
| Medincrease | $165 | 2395% |
Consumer Guidance & Cost Commentary
For this blood test procedure, the facility's cash price of $184.00 is significantly higher than the Medicare benchmark of $6.89, reflecting a markup common in commercial billing where negotiated rates often average 200% to 300% of the federal baseline. While the facility's negotiated rates with nine insurance payers range from $110 to $156, these amounts are still substantially above the Medicare rate, illustrating that commercial contracts frequently exceed fair pricing standards defined as 120% to 150% of Medicare. For patients with high-deductible plans, paying the cash price of $184.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash rate, and the administrative overhead of claims processing can inflate the final bill by 20% to 40%.
To potentially lower costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% by bypassing expensive insurance claims processing and collection fees. It is crucial to request a waiver of insurance submission before check-in to ensure the cash discount applies, as automatic claims submission can void the agreement. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized bills to ensure no unbundled codes or services not rendered have been charged. Always confirm your deductible status before scheduling, as using insurance without meeting your deductible balance can result in paying the full negotiated rate rather than the expected copay.