CMS Price Transparency Data

Blood test, lipase

Facility: University of Miami Hospital and Clinics

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $47
Cash Discount Price: $26
vs. Medicare Baseline: 6.82x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at University of Miami Hospital and Clinics is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.82x the Medicare baseline. Located in 1475 Nw 12Th Ave Suite 2175, Miami, FL.

Cash / Self-Pay

$26

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $26 (377%)

Insurance Median: $47 (682%)

Cash: $26 (377% of Medicare)

Ins. Median: $47 (682% 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 682% of the Medicare baseline (a markup of 582%). 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
Careplus	$2 - $47	29%
Sunshine Health	$2 - $47	29%
Aetna	$3 - $103	44%
Amerihealth Caritas Fl	$3 - $53	44%
Blue Cross Blue Shield	$3 - $370	44%
Molina Healthcare Of Fl	$3 - $51	44%
Oscar Health Of Fl	$3 - $53	44%
Cigna	$4 - $82	58%
Curative	$5 - $100	73%
Avmed	$6 - $122	87%
Employers Health Network	$6 - $113	87%
First Health	$6 - $122	87%
Health First New York Health Insurance	$6 - $122	87%
Simply Healthcare	$6 - $113	87%
Broward Health	$7 - $132	102%
UnitedHealthcare	$7 - $30	102%
Beech Street	$8 - $150	116%
Dimension Health	$8 - $150	116%
Humana	$8	116%
Multiplan	$8 - $150	116%
Solis Health	$8	116%

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 $26.
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 University of Miami Hospital and Clinics 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.