CMS Price Transparency Data

Blood test, lipase

Facility: Mercyone Clinton Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $195
  • Cash Discount Price: $145
  • vs. Medicare Baseline: 28.30x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercyone Clinton Medical Center is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 28.30x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$145

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $145 (2104%)
Insurance Median: $195 (2830%)
Cash: $145 (2104% of Medicare)
Ins. Median: $195 (2830% 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 2830% of the Medicare baseline (a markup of 2730%). 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 - $195 102%
Blue Cross Blue Shield $7 102%
Geha $7 102%
Iowa Total Care $7 102%
Medicaid / KanCare $7 102%
Medicare (plans) $7 102%
UnitedHealthcare $7 - $223 102%
Amish Hospital Aid $9 131%
Oscar $9 131%
Ambetter / Centene $12 174%
Claimdoc $14 203%
Nova $14 203%
Health Choices $63 914%
Medical Associates $63 914%
Preferred Health Choice $64 929%
The Alliance $135 1959%
1199 National Benefit Fund $195 2830%
Allied Benefit Systems $195 2830%
Asr Health Benefits $195 2830%
Christian Brother Services $195 2830%
Coventry $195 2830%
First Health $195 2830%
Lucent Health $195 2830%
Luminare Health $195 2830%
Medical Mutual $195 2830%
Meritain $195 2830%
Trustmark Small Business Benefits $195 2830%
Webtpa $195 2830%
Health Partners $196 2845%
Auxiant $201 2917%
Cigna $201 2917%
Medica $201 2917%
Midlands $201 2917%
Midlands Choice $201 2917%
Multiplan $201 2917%
Qualcare $201 2917%
Usa Managed Care $212 3077%
Crime Victim Assistance $223 3237%
Iowa Dept Of Public Health $223 3237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals