CMS Price Transparency Data

Blood test, lipase

Facility: Mercyone Newton Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $113
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 16.40x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercyone Newton Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 16.40x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $83 (1205%)
Insurance Median: $113 (1640%)
Cash: $83 (1205% of Medicare)
Ins. Median: $113 (1640% 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 1640% of the Medicare baseline (a markup of 1540%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 - $120 102%
Blue Cross Blue Shield $7 102%
Iowa Total Care $7 102%
Medicaid / KanCare $7 102%
Medicare (plans) $7 102%
UnitedHealthcare $7 - $73 102%
Amish Hospital Aid $9 131%
Centivo $10 145%
Oscar $10 145%
Ambetter / Centene $12 174%
Claimdoc $14 203%
Nova $14 203%
Geha $73 1060%
Newton Correctional Facility $83 1205%
Health Choices $97 1408%
Medical Associates $97 1408%
Health Partners $113 1640%
Auxiant $118 1713%
Cigna $118 1713%
Health Alliance $118 1713%
Medica $118 1713%
Midlands $118 1713%
Midlands Choice $118 1713%
1199 National Benefit Fund $120 1742%
Allied Benefit Systems $120 1742%
Asr Health Benefits $120 1742%
Christian Brother Services $120 1742%
Coventry $120 1742%
First Health $120 1742%
Lucent Health $120 1742%
Luminare Health $120 1742%
Medical Mutual $120 1742%
Meritain $120 1742%
Trustmark Small Business Benefits $120 1742%
Webtpa $120 1742%
Crime Victim Assistance $128 1858%
Iowa Dept Of Public Health $128 1858%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals