CMS Price Transparency Data
Blood test, lipase
Facility: Palmetto General Hospital
Billing Code: 83690 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83690
- Insurance Median: $12
- Cash Discount Price: $173
- vs. Medicare Baseline: 1.74x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Palmetto General Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.74x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$173
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
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: $173 (2511%)
Insurance Median: $12 (174%)
Cash: $173 (2511% of Medicare)
Ins. Median: $12 (174% 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.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Cigna | $3 - $160 | 44% |
| Humana | $3 - $130 | 44% |
| Medicaid / KanCare | $3 - $320 | 44% |
| UnitedHealthcare | $3 - $7 | 44% |
| Bc/Bs Myblue Hmo Hix | $4 - $46 | 58% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $4 - $49 | 58% |
| Bc/Bs Of Fl Health Options Hmo | $4 - $49 | 58% |
| Bc/Bs Of Fl Network Blue | $4 - $46 | 58% |
| Bc/Bs Of Fl Ppo | $4 - $49 | 58% |
| Bc/Bs Of Fl Simplyblue | $4 - $46 | 58% |
| Bc/Bs Of Fl Miami Dade Blue Select | $5 - $65 | 73% |
| Veterans Administration Mill Bill | $5 | 73% |
| Avmed Broad Network | $6 | 87% |
| Medicare (plans) | $6 - $320 | 87% |
| Aetna | $7 - $228 | 102% |
| Bristol Hospice- Miami Dade Llc | $7 | 102% |
| Catholic Hospice | $7 | 102% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $7 | 102% |
| Devoted Health | $7 | 102% |
| Employer Direct Healthcare | $7 - $9 | 102% |
| Healthsun Health Plans | $7 | 102% |
| Hospice Other | $7 | 102% |
| Ima Evalutations Inc | $7 | 102% |
| Leon Health Inc | $7 | 102% |
| Longevity Health Plan | $7 | 102% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $7 | 102% |
| Opuscare Of South Fl | $7 | 102% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $7 | 102% |
| Select Specialty Hospital | $7 | 102% |
| Tricare | $7 | 102% |
| Veterans Administration Vaccn | $7 | 102% |
| Vitas Healthcare Hospice | $7 | 102% |
| Westchester General Hospital | $7 | 102% |
| Bright Health Management Commercial | $8 | 116% |
| Florida Pace Centers | $8 | 116% |
| Imagine Health | $8 | 116% |
| Oscar Health Plan Hix | $8 | 116% |
| Self Pay/Uninsured | $8 | 116% |
| Naphcare Inc | $9 | 131% |
| Avmed Exchange | $12 | 174% |
| Bc/Bs Of Fl Phs | $12 - $161 | 174% |
| Dimension Health Wc | $12 | 174% |
| Liga Contra El Cancer | $12 - $160 | 174% |
| Workers Compensation | $12 | 174% |
| Ambetter / Centene | $13 | 189% |
| Molina Marketplace Program Exchange | $13 | 189% |
| Auto Insurance | $14 | 203% |
| Avmed Select Network | $14 | 203% |
| Amerihealth Caritas Next Exchange | $15 | 218% |
| Magellan Behavioral Health | $15 - $192 | 218% |
| Dimensions International | $16 - $208 | 232% |
| First Health | $17 - $215 | 247% |
| Dimension Health Ppo | $19 - $240 | 276% |
| Beacon Health Strategies Commercial | $25 - $320 | 363% |
| Commercial Non-Contracted | $25 - $320 | 363% |
| Self Pay - Mcd Pending 100 Percent | $25 - $320 | 363% |
| Single Case Agreement | $25 - $320 | 363% |
| United Behavioral Health Psych | $25 - $320 | 363% |