CMS Price Transparency Data

Blood test, lipase

Facility: St Josephs Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $37
Cash Discount Price: $25
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at St Josephs Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.37x the Medicare baseline. Located in 3001 W Martin Luther King Jr Blvd, Tampa, FL.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $25 (363%)

Insurance Median: $37 (537%)

Cash: $25 (363% of Medicare)

Ins. Median: $37 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Aetna	$3 - $209	44%
Clear Health Alliance	$3	44%
Florida Community Care	$3	44%
Freedom Health	$3	44%
Humana	$3 - $9	44%
Molina Healthcare	$3	44%
Simply Healthcare	$3 - $46	44%
Sunshine Health	$3	44%
UnitedHealthcare	$3 - $230	44%
Baycareplus	$7	102%
Blue Cross Blue Shield	$7 - $135	102%
Cigna	$8 - $223	116%
Freedom	$8 - $51	116%
Molina	$8 - $151	116%
Optimum	$8 - $51	116%
Solis Health	$8	116%
Careplus	$10 - $58	145%
Wellcare	$10	145%
Avmed	$13 - $125	189%
Ultimate Health Plan	$13 - $77	189%
Ambetter / Centene	$16 - $256	232%
Evolutions	$21 - $238	305%
First Health	$36 - $218	522%
Multiplan	$38 - $230	552%
United Behavioral Health	$42 - $256	610%

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 $25.
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 St Josephs 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.