CMS Price Transparency Data

Blood test, lipase

Facility: Nemours Children's Hospital, Delaware

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $122
  • Cash Discount Price: $250
  • vs. Medicare Baseline: 17.71x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Nemours Children's Hospital, Delaware is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $250. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 17.71x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$250

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $250 (3628%)
Insurance Median: $122 (1771%)
Cash: $250 (3628% of Medicare)
Ins. Median: $122 (1771% 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 1771% of the Medicare baseline (a markup of 1671%). 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
Carefirst Md Community Health Plan $7 102%
Priority Partners John Hopkins $7 - $166 102%
Tricare $7 102%
Us Family Health Plan $8 116%
Celtic Transplant $12 - $339 174%
Keystone First Hlth Plan $21 - $150 305%
Amerihealth Caritas Delaware $32 - $193 464%
Blue Cross Blue Shield $32 - $299 464%
Celtic Transplant For De First Health $36 - $119 522%
Delaware First Health $37 - $122 537%
UnitedHealthcare $38 - $212 552%
Wellpoint Maryland $38 - $125 552%
Kidz Partners $39 - $128 566%
Health Partners $40 - $132 581%
Fidelis $41 - $136 595%
Upmc $41 - $134 595%
Aetna $44 - $197 639%
Six Degrees Health Transplant $52 - $170 755%
Cigna $57 - $214 827%
Great West-One Health Plan $57 - $214 827%
Ambetter / Centene $59 - $193 856%
Geisinger Health Plan $62 - $203 900%
Integra Administrative Group $62 - $203 900%
National Transplant Network (Ntn) $67 - $220 972%
Six Degrees Health $67 - $220 972%
Star Healthcare Network $67 - $220 972%
Life Trac Solid Organ And Bmt Transplant $72 - $237 1045%
First Health Network $98 - $322 1422%
Insurance Administrators Of America $98 - $322 1422%
Interlink Transplant Network $98 - $322 1422%
Multiplan $98 - $322 1422%
Preferred Healthcare $98 - $322 1422%
Private Healthcare Systems $98 - $322 1422%
Three Rivers Provider Network $98 - $322 1422%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens