CMS Price Transparency Data

Blood test, lipase

Facility: Memorial Hospital, The

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $111
Cash Discount Price: $84
vs. Medicare Baseline: 16.11x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Memorial Hospital, The is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 16.11x the Medicare baseline. Located in 750 Hospital Loop, Craig, CO.

Cash / Self-Pay

$84

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $84 (1219%)

Insurance Median: $111 (1611%)

Cash: $84 (1219% of Medicare)

Ins. Median: $111 (1611% 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 1611% of the Medicare baseline (a markup of 1511%). 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
Care Advantage	$48 - $130	697%
Cvs Caremark-Part D	$48 - $130	697%
Denver Health	$48 - $130	697%
Humana	$48 - $130	697%
Kaiser	$48 - $130	697%
Rmhp Dualcare	$48 - $130	697%
Blue Cross Blue Shield	$75 - $130	1089%
Golden Rule Ins	$110	1597%
UnitedHealthcare	$110 - $130	1597%
Allegiance	$111	1611%
Cigna	$111	1611%
Geha	$111	1611%
Great West Hlthcare	$111	1611%
Health Partners	$111	1611%
Aetna	$114 - $130	1655%
Multiplan Inc Ppo	$119 - $123	1727%
First Health Other	$123	1785%

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 $84.
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 Memorial Hospital, The 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.