CMS Price Transparency Data

Blood test, lipase

Facility: Memorial Hospital and Manor

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $147
Cash Discount Price: $134
vs. Medicare Baseline: 21.34x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Memorial Hospital and Manor is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 21.34x the Medicare baseline. Located in 1500 E Shotwell Street, Bainbridge, GA.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $134 (1945%)

Insurance Median: $147 (2134%)

Cash: $134 (1945% of Medicare)

Ins. Median: $147 (2134% 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 2134% of the Medicare baseline (a markup of 2034%). 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
Tricare	$6	87%
Aetna	$7 - $172	102%
Humana	$7 - $153	102%
Medicare (plans)	$7	102%
Wellcare_Plan	$7	102%
Ambetter / Centene	$9	131%
Amerigroup_Plan	$9	131%
Caresource_Plan	$9	131%
Medicaid / KanCare	$9	131%
Peach_State_Health_Plan_Plan	$9	131%
Alliant_Plan	$11	160%
Blue Cross Blue Shield	$147	2134%
Uhc_Plan	$151	2192%
Novanet_Plan	$153	2221%
Cigna	$159	2308%
Private_Healthcare_Systems_Plan	$162	2351%
Multiplan_Plan	$172	2496%
Corvel_Plan	$181	2627%
Tnga_Plan	$450	6531%

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 $134.
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 Memorial Hospital and Manor 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.