CMS Price Transparency Data

Blood test, lipase

Facility: Boulder Community Health

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $58
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 8.42x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Boulder Community Health is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.42x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $77 (1118%)
Insurance Median: $58 (842%)
Cash: $77 (1118% of Medicare)
Ins. Median: $58 (842% 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 842% of the Medicare baseline (a markup of 742%). 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
Blue Cross Blue Shield $3 - $91 44%
UnitedHealthcare $3 - $7 44%
Aetna $5 - $133 73%
Humana $5 - $7 73%
Health Spring $6 87%
Medicare (plans) $6 - $58 87%
Select Health Colorado Public Option $6 - $58 87%
Select Health Value Network $6 - $58 87%
Clear Spring $7 102%
Devoted Health $7 - $61 102%
Rocky Mountain Health Maintenance Organization $7 102%
Cigna $8 - $122 116%
Multiplan $11 - $107 160%
Phcs $11 - $107 160%
Kaiser Public Option $13 189%
Kaiser $16 232%
Kaiser Ppo $16 232%
Rocky Mountain Health Maintenance Organization Private Plan $107 1553%
Integrated Health Plans Bch $115 1669%
Casualty Management Network, Prime Health Services Behavioral Health $130 1887%
Mines And Associates $130 1887%
Three Rivers Provider Network $130 1887%
Zelis (Profee) $130 1887%
Casualty Management Network, Prime Health Services Community Medical Associates $138 2003%
National Preferred Provider Network $138 2003%
Rockport Healthcare Group Community Medical Associates $138 2003%
Usa $138 2003%
Rockport Healthcare Group Bch $142 2061%
Health Payors Organization $145 2104%
Health Management Network Bch Community Medical Associates $147 2134%
Health Management Network Community Medical Associates $147 2134%
National Provider Network $148 2148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals