CMS Price Transparency Data

Blood test, lipase

Facility: Grady Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $45
Cash Discount Price: $204
vs. Medicare Baseline: 6.53x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Grady Memorial Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.53x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.

Cash / Self-Pay

$204

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: $204 (2961%)

Insurance Median: $45 (653%)

Cash: $204 (2961% 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	$7 - $125	102%
Ambetter / Centene	$7 - $42	102%
Blue Cross Blue Shield	$7 - $226	102%
Cigna	$7 - $167	102%
Clear Spring Health	$7	102%
Clover	$7	102%
Humana	$7	102%
Kaiser	$7 - $214	102%
Medicare (plans)	$7	102%
UnitedHealthcare	$7 - $203	102%
Vaccn	$7	102%
Wellcare	$7	102%
Usp Naphcare	$8 - $169	116%
Amerigroup	$9 - $46	131%
Caresource	$9 - $42	131%
Peach State	$9 - $42	131%
Oscar Health	$10 - $183	145%
Multiplan	$96 - $217	1393%

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 $204.
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 Grady Memorial 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.