CMS Price Transparency Data

Blood test, lipase

Facility: Boone County Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $17
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Boone County Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.47x the Medicare baseline. Located in 1015 Union Street, Boone, IA.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $26 (377%)
Insurance Median: $17 (247%)
Cash: $26 (377% of Medicare)
Ins. Median: $17 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
Va Ccn-All Plans $2 - $5 29%
Aetna $5 - $56 73%
Amerigroup Mcr Adv - All Other Plans $5 - $30 73%
Choice Care Mcr Adv - All Plans $5 - $30 73%
Humana $5 - $65 73%
Iowa Hlth Adv - All Plans $5 - $30 73%
Iowa Total Care Mcaid - All Plans $5 - $33 73%
Medicaid / KanCare $5 - $34 73%
Meridian Mcaid - All Plans $5 - $33 73%
Mt Carmel Hp - All Plans $5 - $30 73%
UnitedHealthcare $6 - $42 87%
Tricare $7 102%
Healthsmart Accell Network $8 - $51 116%
Medical Associates Hp-All Plans $8 - $54 116%
Healthsmart Ppo - All Other Plans $9 - $58 131%
Health Alliance-All Plans $10 - $65 145%
Midlands Choice-All Plans $10 - $67 145%
Mutually Preferred-All Plans $10 - $69 145%
Wellmark Hmo $23 334%
Wellmark Ppo - All Other Plans $25 363%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Union Street, Boone, IA 50036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals