CMS Price Transparency Data

Blood test, lipase

Facility: Decatur County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $78
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 11.32x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Decatur County Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 11.32x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$78

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: $78 (1132%)
Insurance Median: $78 (1132%)
Cash: $78 (1132% of Medicare)
Ins. Median: $78 (1132% 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 1132% of the Medicare baseline (a markup of 1032%). 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
UnitedHealthcare $7 - $82 102%
Wellmark Hmo $20 290%
Wellmark Ppo - All Other Plans $23 334%
Blue Cross Blue Shield $31 450%
Champva -All Plans $44 639%
Everystep Hospice-All Plans $50 726%
Aetna $52 - $77 755%
Tricare $52 755%
Benefit Admin System-All Plans $63 914%
Humana $71 1030%
Meritain Health-All Plans $71 1030%
Misc Commercial-All Plans $71 1030%
All Savers-All Plans $73 1060%
Allied Benefit System-All Plans $73 1060%
American Family Ins Grp-All Plans $73 1060%
Rural Carrier Benefit Plan-All Plans $75 1089%
Christian Healthcare -All Plans $78 1132%
Medica-All Other Plans $78 1132%
Golden Rule-All Plans $82 1190%
Ntca The Rural Broadband-All Plans $82 1190%
Cigna $83 1205%
Medical Mutual-All Plans $85 1234%
Farm Bureau Financial-All Other Plans $87 1263%
Farm Bureau Property And Ca $87 1263%
Medi Share-All Plans $88 1277%
Uhss-All Plans $88 1277%
Health Partners-All Plans $89 1292%
Lewermark-All Plans $92 1335%
Mail Handlers Benefit-All Plans $95 1379%
Midlands Choice-All Plans $95 1379%
Priority Health-All Plans $97 1408%
Iowa Total Care Mcaid-All Plans $99 1437%
Amerigroup Mcaid-All Plans $102 1480%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals