CMS Price Transparency Data
Blood test, lipase
Facility: Mercy Hospital Ozark
Billing Code: 83690 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83690
- Insurance Median: $64
- Cash Discount Price: $62
- vs. Medicare Baseline: 9.29x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Hospital Ozark is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.29x the Medicare baseline. Located in 801 West River Street, Ozark, AR.
Cash / Self-Pay
$62
Average discount available for prompt cash payment at this facility.
Insurance Median
$64
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: $62 (900%)
Insurance Median: $64 (929%)
Cash: $62 (900% of Medicare)
Ins. Median: $64 (929% 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 929% of the Medicare baseline (a markup of 829%). 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.
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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 | $6 - $43 | 87% |
| Aetna | $7 - $69 | 102% |
| American Health Advantage Of Mo Mcr [20264] | $7 | 102% |
| Blue Cross Blue Shield | $7 - $11 | 102% |
| Cherokee Nation Health Serv Contracted [320066] | $7 | 102% |
| Cigna | $7 - $90 | 102% |
| Cross Timbers Hospice [20098] | $7 | 102% |
| Dept Of Veteran Affairs Contracted [320106] | $7 | 102% |
| Elara Caring Aspire Hospice Contracted [320433] | $7 | 102% |
| Elara Caring Aspire Hospice [20433] | $7 | 102% |
| Globalhealth Contracted [320145] | $7 | 102% |
| Halo Hcr Inc Hospice Contracted [320432] | $7 | 102% |
| Halo Hcr Inc Hospice [20432] | $7 | 102% |
| Humana | $7 - $90 | 102% |
| Independent Health [20197] | $7 | 102% |
| Indian Health Service Contracted [320198] | $7 | 102% |
| Indian Health Service [20198] | $7 | 102% |
| Jordan Valley Senior Care Pace [20515] | $7 | 102% |
| Kindful Hospice Contracted [320434] | $7 | 102% |
| Kindful Hospice [20434] | $7 | 102% |
| Medical Associates Health [20444] | $7 | 102% |
| Medicare (plans) | $7 | 102% |
| Mercy Hospice Okc [20252] | $7 | 102% |
| Pace Of The Ozarks [20518] | $7 | 102% |
| Provider Partners Health Plans Contracted [320450] | $7 | 102% |
| Qual Choice Contracted [320325] | $7 | 102% |
| Spina Bifida Hlthcare Benefit [20506] | $7 | 102% |
| United Medical Resources Contracted [320454] | $7 | 102% |
| UnitedHealthcare | $7 | 102% |
| Valir Pace [20503] | $7 | 102% |
| Wellfirst Health Mcr [20443] | $7 | 102% |
| Summit Community Care Contracted [320368] | $10 | 145% |
| Summit Community Care [20368] | $10 | 145% |
| Usable Contracted [320409] | $11 | 160% |
| Novasys Contracted [320285] | $17 - $43 | 247% |
| Arkansas Total Care Contracted [320039] | $22 | 319% |
| Tricare | $25 - $31 | 363% |
| Mercy Interfacility [20513] | $28 - $35 | 406% |
| Qual Choice Contracted [320324] | $30 | 435% |
| Ambetter / Centene | $35 - $43 | 508% |
| Home State Health Plan Contracted [320187] | $35 - $43 | 508% |
| Auxiant Contracted [320462] | $52 - $95 | 755% |
| Mercy Benefit Admin Contracted [320251] | $52 - $95 | 755% |
| Workers Comp [20426] | $56 - $69 | 813% |
| 90 Degree Benefits Contracted [320436] | $73 - $90 | 1060% |
| Aither Health Contracted [320449] | $73 - $90 | 1060% |
| Ebms Contracted [320493] | $73 - $90 | 1060% |
| Edison Health Solutions Contracted [320502] | $73 - $90 | 1060% |
| Healthlink Contracted [320179] | $73 - $95 | 1060% |
| Imagine 360 Contracted [320494] | $73 - $90 | 1060% |
| Multiplan Contracted [320270] | $73 - $90 | 1060% |
| Multiplan [20270] | $73 - $90 | 1060% |
| Municipal Health Plan Contracted [320271] | $73 - $90 | 1060% |
| Reflect Health Contracted [320492] | $73 - $90 | 1060% |
| Show-Me Health Administrators Contracted [320483] | $73 - $90 | 1060% |
| Federal Medical Center Contracted [320127] | $77 - $95 | 1118% |
| Healthscope Contracted [320182] | $77 - $95 | 1118% |
| Insurance System Inc Contracted [320465] | $77 - $95 | 1118% |
| Personify Health Contracted [320051] | $77 - $95 | 1118% |
| Point C Contracted [320238] | $77 - $95 | 1118% |
| Preferred Health Plan Contracted [320522] | $77 - $95 | 1118% |
| Tri State Healthcare Coalition Contracted [320379] | $77 - $95 | 1118% |