CMS Price Transparency Data

Blood test, lipase

Facility: Craig Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $702
Cash Discount Price: $389
vs. Medicare Baseline: 101.89x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Craig Hospital is $702. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $389. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 101.89x the Medicare baseline. Located in 3425 S Clarkson St, Englewood, CO.

Cash / Self-Pay

$389

Average discount available for prompt cash payment at this facility.

Insurance Median

$702

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: $389 (5646%)

Insurance Median: $702 (10189%)

Cash: $389 (5646% of Medicare)

Ins. Median: $702 (10189% 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 10189% of the Medicare baseline (a markup of 10089%). 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
Veterans Administration	$6	87%
Cms	$7	102%
UnitedHealthcare	$7 - $508	102%
Cigna	$516	7489%
Kaiser	$531	7707%
Blue Cross Blue Shield	$541	7852%
Carisk Outcomes	$562	8157%
Zenith	$609	8839%
Aetna	$637	9245%
Corvel Worker'S Comp	$655	9507%
Liberty Mutual Worker'S Comp	$655	9507%
Paradigm	$655 - $693	9507%
Rocky Mountain Health Plan	$683 - $730	9913%
Midwest Employers Casualty	$693	10058%
Coventry/First Health	$702	10189%
Fcci Worker'S Comp	$702	10189%
Geha/Ppo Usa	$702	10189%
Great-West Healthcare	$702	10189%
Multiplan/Phcs	$702 - $740	10189%
Prime Health Services	$712	10334%
First Choice Health	$730	10595%
Focus Worker'S Comp	$749	10871%
General Reinsurance	$749 - $796	10871%
Provider Network Of America	$749	10871%
Three Rivers Provider Network	$749 - $768	10871%
Wyoming Worker'S Comp	$749	10871%
Allstate	$796	11553%
Tricare	$796	11553%
National Provider Network	$843	12235%
Up & Up	$843	12235%

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 $389.
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 Craig Hospital 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.