CMS Price Transparency Data

Blood test, lipase

Facility: East Morgan County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $25
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 3.63x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at East Morgan County Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.63x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.
Cash / Self-Pay
$32

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: $32 (464%)
Insurance Median: $25 (363%)
Cash: $32 (464% 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.

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
Aetna $9 - $54 131%
Banner Health $9 - $25 131%
Blue Cross Blue Shield $9 - $53 131%
Clear Spring Health $9 - $25 131%
Healthspring Life & Health Insurance Company, Inc. $9 - $25 131%
Longevity $9 - $26 131%
Medica $9 - $48 131%
Medicare (plans) $9 - $25 131%
Pinnacol Assurance Workers Comp $9 - $24 131%
Triwest Healthcare Alliance Corp - Va Ccn $9 - $25 131%
UnitedHealthcare $9 - $54 131%
Devoted Health Services $10 - $27 145%
Humana $10 - $26 145%
Assist Health Group $11 - $30 160%
Denver Health Medical Plan $17 - $46 247%
Apostrophe, Inc. $19 - $52 276%
First Choice Health Network $19 - $52 276%
Hue Health, Inc $20 - $55 290%
Multiplan $20 - $56 290%
Rocky Mountain Health Plans $20 - $55 290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 W Edison St, Brush, CO 80723
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals