CMS Price Transparency Data

Blood test, lipase

Facility: Fishermen's Community Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $45
Cash Discount Price: $65
vs. Medicare Baseline: 6.53x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Fishermen's Community Hospital is $45. 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 6.53x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $45 (653%)

Cash: $65 (943% of Medicare)

Ins. Median: $45 (653% 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 653% of the Medicare baseline (a markup of 553%). 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 - $108	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	$10 - $141	145%
Leon Medical	$13 - $30	189%
Medica Health Plan	$13 - $30	189%
Medicare (plans)	$13 - $40	189%
Avmed	$14 - $117	203%
Cigna	$14 - $113	203%
Humana	$14 - $32	203%
Non Contracted	$22 - $52	319%
International	$39 - $92	566%
Amerihealth	$45 - $106	653%
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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $65.
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 Fishermen's Community 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.