CMS Price Transparency Data

Blood test, lipase

Facility: Grandview Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $24
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 3.48x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Grandview Medical Center is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.48x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$24

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: $16 (232%)
Insurance Median: $24 (348%)
Cash: $16 (232% of Medicare)
Ins. Median: $24 (348% 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 348% of the Medicare baseline (a markup of 248%). 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.

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
Medicaid / KanCare $5 73%
Bc Pml $6 87%
Node Champva $6 87%
Tricare $6 87%
UnitedHealthcare $6 - $36 87%
Aetna $7 - $8 102%
Blue Advantage $7 102%
Cigna $7 - $13 102%
Hospice $7 102%
Humana $7 102%
Medicare (plans) $7 102%
Node Clover Health Mcr Adv $7 102%
Node Devoted Health Mcr Adv $7 102%
Node Va $7 102%
Node Wellcare Mcr Adv $7 102%
Select Health $7 102%
Veterans Eval Services $7 102%
Victory Health $7 102%
Viva Health $7 - $45 102%
Blue Cross Blue Shield $8 116%
Node Us Dept Of Labor $9 131%
Ambetter / Centene $10 145%
Healthspring $12 174%
Self Pay $12 - $19 174%
Bp Health Advocate $20 290%
Ag Administrators $28 406%
Alamed $28 406%
Choicecare $28 406%
Drummond $28 406%
American Employee Alliance $32 464%
Healthchoice $40 - $49 581%
Value Options $40 581%
First Health $49 - $63 711%
Multiplan $49 - $57 711%
Blue Bell Creameries $57 827%
Natl Comp Care $61 885%
Usa Ppo $61 885%
Coventry Work Comp Al $63 914%
Novanet $65 943%
Alabama Wc $69 1001%
Cal-Med $69 1001%
Corvel $69 1001%
Associated Admin $73 1060%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals