CMS Price Transparency Data

Blood test, lipase

Facility: Mercyone Oelwein Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $118
Cash Discount Price: $83
vs. Medicare Baseline: 17.13x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Mercyone Oelwein Medical Center is $118. 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 17.13x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $118 (1713%)

Cash: $83 (1205% of Medicare)

Ins. Median: $118 (1713% 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 1713% of the Medicare baseline (a markup of 1613%). 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
Medicare (plans)	$49 - $55	711%
Iowa Total Care	$50	726%
Medicaid / KanCare	$50 - $51	726%
Blue Cross Blue Shield	$52	755%
UnitedHealthcare	$56 - $91	813%
Aetna	$60 - $118	871%
Amish Hospital Aid	$70	1016%
Centivo	$79	1147%
Ambetter / Centene	$88	1277%
Geha	$91	1321%
Health Choices	$94	1364%
Medical Associates	$94	1364%
Claimdoc	$105	1524%
Nova	$105	1524%
1199 National Benefit Fund	$118	1713%
Allied Benefit Systems	$118	1713%
Asr Health Benefits	$118	1713%
Christian Brother Services	$118	1713%
Coventry	$118	1713%
First Health	$118	1713%
Lucent Health	$118	1713%
Luminare Health	$118	1713%
Medical Mutual	$118	1713%
Meritain	$118	1713%
Trustmark Small Business Benefits	$118	1713%
Webtpa	$118	1713%
Health Partners	$123	1785%
Multiplan	$124	1800%
Auxiant	$125	1814%
Cigna	$125	1814%
Medica	$125	1814%
Midlands	$125	1814%
Midlands Choice	$125	1814%
Crime Victim Assistance	$128	1858%
Iowa Dept Of Public Health	$128	1858%

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 $83.
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 Mercyone Oelwein Medical Center 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.