CMS Price Transparency Data

Blood test, lipase

Facility: Sterling Regional Medcenter

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $25
Cash Discount Price: $17
vs. Medicare Baseline: 3.63x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Sterling Regional Medcenter is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.63x the Medicare baseline. Located in 615 Fairhurst St, Sterling, CO.

Cash / Self-Pay

$17

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

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: $17 (247%)

Insurance Median: $25 (363%)

Cash: $17 (247% of Medicare)

Ins. Median: $25 (363% 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 363% of the Medicare baseline (a markup of 263%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$6 - $54	87%
Banner Health	$7 - $18	102%
Blue Cross Blue Shield	$7 - $65	102%
Clear Spring Health	$7	102%
Healthspring Life & Health Insurance Company, Inc.	$7 - $18	102%
Humana	$7	102%
Longevity	$7	102%
Medica	$7 - $48	102%
Medicare (plans)	$7 - $18	102%
UnitedHealthcare	$7 - $55	102%
Assist Health Group	$8 - $22	116%
Devoted Health Services	$8	116%
Pinnacol Assurance Workers Comp	$10 - $28	145%
Denver Health Medical Plan	$13 - $35	189%
Apostrophe, Inc.	$19 - $52	276%
First Choice Health Network	$19 - $52	276%
First Choice Of The Midwest	$20 - $55	290%
Hue Health, Inc	$20 - $55	290%
Multiplan	$20 - $56	290%
Rocky Mountain Health Plans	$20 - $55	290%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $17.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83690.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sterling Regional Medcenter is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83690.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.