CMS Price Transparency Data

Blood test, lipase

Facility: Monroe County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $64
Cash Discount Price: $77
vs. Medicare Baseline: 9.29x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Monroe County Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.29x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $77 (1118%)

Insurance Median: $64 (929%)

Cash: $77 (1118% of Medicare)

Ins. Median: $64 (929% 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 929% of the Medicare baseline (a markup of 829%). 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
Wellmark Hmo	$6	87%
Wellmark Ppo - All Other Plans	$7	102%
Va Ccn - All Plans	$9	131%
Mahp Mcare - All Plans	$54	784%
Tricare	$54	784%
UnitedHealthcare	$54 - $123	784%
Aetna	$55 - $121	798%
Amerigroup Mcare	$55	798%
Humana	$55	798%
Wellmark Mcare	$55	798%
Iowa Total Care Mcaid - All Plans	$64	929%
Molina Mcaid - All Plans	$65	943%
Amerigroup Mcaid - All Other Plans	$66	958%
Centivo - All Plans	$81	1176%
Midlands Choice - All Plans	$90	1306%
Preferred Hlth - All Plans	$97	1408%
Geha - All Plans	$103	1495%
Multiplan - All Plans	$116	1684%
Integrated Hp - All Plans	$125	1814%

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 $77.
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 Monroe County 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.