CMS Price Transparency Data

Blood test, lipase

Facility: Clinch Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $61
Cash Discount Price: $32
vs. Medicare Baseline: 8.85x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Clinch Memorial Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.85x the Medicare baseline. Located in 1050 Valdosta Highway, Homerville, GA.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $32 (464%)

Insurance Median: $61 (885%)

Cash: $32 (464% of Medicare)

Ins. Median: $61 (885% 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 885% of the Medicare baseline (a markup of 785%). 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	$51 - $64	740%
UnitedHealthcare	$53	769%
Cigna	$54	784%
Blue Cross Blue Shield	$55	798%
Novanet	$57	827%
Alliant	$61 - $64	885%
Caresource	$61 - $64	885%
Devoted	$61 - $64	885%
Eon Health	$61 - $64	885%
Humana	$61 - $64	885%
Peach State Health Plan	$61 - $64	885%
Amerigroup	$64	929%
Clover	$64	929%
Wellcare	$64	929%

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 $32.
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 Clinch 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.