CMS Price Transparency Data

Blood test, lipase

Facility: Emory Hillandale Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $7
Cash Discount Price: $166
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Emory Hillandale Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.02x the Medicare baseline. Located in 2801 Dekalb Medical Parkway, Lithonia, GA.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $166 (2409%)

Insurance Median: $7 (102%)

Cash: $166 (2409% of Medicare)

Ins. Median: $7 (102% 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.

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
Blue Cross Blue Shield	$5 - $7	73%
Aetna	$7 - $10	102%
Cigna	$7	102%
Clover Health	$7	102%
Devoted Health	$7	102%
UnitedHealthcare	$7	102%
Wellcare	$7	102%
Oscar Health	$9	131%
Kaiser	$10	145%
Ambetter / Centene	$15	218%

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 $166.
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 Emory Hillandale 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.