CMS Price Transparency Data

Blood test, lipase

Facility: Marion Communtiy Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $128
  • Cash Discount Price: $970
  • vs. Medicare Baseline: 18.58x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Marion Communtiy Hospital is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $970. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 18.58x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$970

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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: $970 (14078%)
Insurance Median: $128 (1858%)
Cash: $970 (14078% of Medicare)
Ins. Median: $128 (1858% 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 1858% of the Medicare baseline (a markup of 1758%). 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
Humana $6 - $261 87%
Align Senior Care $7 102%
American Health Plan $7 102%
Avmed $7 - $365 102%
Blue Cross Blue Shield $7 102%
Cigna $7 102%
Devoted Health $7 102%
Florida Complete Care $7 102%
Freedom Optimum $7 102%
Ndms Definitive Care $7 102%
Secur $7 102%
Sunshine State $7 102%
United $7 - $586 102%
Va Purchased Care Program $7 102%
Veterans Evaluation Services $7 102%
Wellcare $7 102%
Wellmed $7 102%
Aetna $8 - $391 116%
Careplus $8 116%
Centurion $8 116%
Clear Spring Health $8 116%
Gold Kidney Of Florida $8 116%
Longevity Health Plan $8 116%
Ultimate Health Plan $8 116%
Simply Healthcare $9 131%
Naphcare $14 - $17 203%
University Ma Federal Corrections $14 203%
Wellpath $14 - $17 203%
Simply $98 - $201 1422%
Molina Healthcare $121 - $417 1756%
Corvel Corporation $142 2061%
Prime Health $145 2104%
Evolutions $147 - $300 2134%
Evolutions Healthcare $147 - $300 2134%
Careworks (Rockport Community) $149 2163%
Marion County Schools $149 2163%
Sunshine State Health Plan $163 - $332 2366%
Plotkin Health $319 - $651 4630%
Prime Health Sheriff $319 - $651 4630%
Multiplan $498 - $1,016 7228%
Ppo Next $542 - $1,107 7866%
Novanet $574 - $1,172 8331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals