CMS Price Transparency Data

Blood test, lipase

Facility: West Kendall Baptist Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $39
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at West Kendall Baptist Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.66x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $65 (943%)
Insurance Median: $39 (566%)
Cash: $65 (943% of Medicare)
Ins. Median: $39 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Aetna $3 - $113 44%
Amerigroup $3 44%
Medicaid / KanCare $3 44%
Sunshine State $3 44%
UnitedHealthcare $3 - $141 44%
Vista $3 44%
Wellcare $3 44%
Blue Cross Blue Shield $7 - $91 102%
Medica Health Plan $7 102%
Medicare (plans) $7 - $9 102%
Avmed $8 - $69 116%
Cigna $8 - $113 116%
Humana $8 116%
Leon Medical $8 116%
Non Contracted $22 - $52 319%
Amerihealth $27 - $63 392%
International $39 - $92 566%
Dimension Health Plan $45 - $127 653%
Affordable $54 - $127 784%
Phcs $54 - $127 784%
Quality Health $54 - $127 784%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals