CMS Price Transparency Data

Blood test, lipase

Facility: Piedmont Augusta Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $41
Cash Discount Price: $77
vs. Medicare Baseline: 5.95x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Piedmont Augusta Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.95x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$41

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: $77 (1118%)

Insurance Median: $41 (595%)

Cash: $77 (1118% of Medicare)

Ins. Median: $41 (595% 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 595% of the Medicare baseline (a markup of 495%). 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
Medicaid / KanCare	$4 - $7	58%
UnitedHealthcare	$6	87%
Blue Cross Blue Shield	$7 - $41	102%
Absolute Total Care [20109]	$11	160%
Cigna	$15	218%
Alliant Health Plans Of Georgia [10952]	$95	1379%
Alliant Solocare [11101]	$95	1379%
Medcost [10966]	$102	1480%
Multiplan [10600]	$113	1640%
Phcs [10601]	$113	1640%
Industry Buying Group [10840]	$166	2409%
Kaiser [10500]	$190	2758%
First Health [10303]	$218	3164%
Novanet [10819]	$230	3338%

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 $77.
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 Piedmont Augusta 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.