CMS Price Transparency Data

Blood test, lipase

Facility: St Francis Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $78
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 11.32x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at St Francis Hospital is $78. 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 11.32x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$78

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: $78 (1132%)
Cash: $84 (1219% of Medicare)
Ins. Median: $78 (1132% 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 1132% of the Medicare baseline (a markup of 1032%). 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 $7 - $86 102%
Blue Cross Blue Shield $7 - $116 102%
Blue Shield - De (Highmark) Medciare Advantage $7 102%
Cigna $7 - $82 102%
Highmark Health Options Dual Plan $7 102%
Medicare (plans) $7 102%
Pace-Trinity Health $7 102%
Saint Francis Life $7 102%
Coventry $8 116%
Delaware First Health $15 218%
Medicaid / KanCare $44 - $47 639%
Blue Benefit Administrators Of Massachusetts $46 668%
Blue Care Network $46 668%
Blue Distinction Transplant $46 668%
Blue Shield - Ca $46 668%
Blue Shield - Id (Regence) $46 668%
Blue Shield - Ny Highmark Northeastern $46 668%
Blue Shield - Ny Highmark Western $46 668%
Blue Shield - Pa (Highmark) $46 668%
Blue Shield - Wa (Regence) $46 668%
Meritain $82 - $86 1190%
Trustmark Small Business Benefits $82 - $86 1190%
Amerihealth $116 1684%
Devon Health Services $120 - $126 1742%
Galaxy Health Network $120 - $126 1742%
Multiplan $120 - $126 1742%
Prime Health Services $120 - $126 1742%
Three Rivers Provider Network $120 - $126 1742%
Wc Corvel $120 - $126 1742%
Geha $121 - $128 1756%
UnitedHealthcare $121 - $128 1756%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals