CMS Price Transparency Data

Blood test, lipase

Facility: Cass County Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $37
Cash Discount Price: $62
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Cass County Memorial Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.37x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $62 (900%)

Insurance Median: $37 (537%)

Cash: $62 (900% of Medicare)

Ins. Median: $37 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
UnitedHealthcare	$7 - $37	102%
Midlands Choice Medica Mcr	$18	261%
Wellmark Hmo	$32	464%
Wellmark Ppo - All Other Plans	$35	508%
Triwest - All Plans	$36	522%
Aetna	$37 - $84	537%
Amerigroup Mcr Adv - All Other Plans	$37	537%
Medica Mcr Adv	$37	537%
Tricare	$37	537%
Va Ccn - All Plans	$37	537%
Wellmark Mcr Adv	$37	537%
American Hlth Mcr Adv - All Plans	$38	552%
Iowa Total Care Mcaid	$38	552%
Iowa Total Care Mcr	$38	552%
Medicaid / KanCare	$38	552%
Molina Mcaid - All Plans	$38	552%
Iowa Total Care Comm - All Other Plans	$41	595%
Midlands Choice New Bus	$57	827%
Medica Comm - All Other Plans	$77	1118%
Midlands Choice Pho (Ppo) - All Other Plans	$79	1147%
Multiplan - All Plans	$84	1219%

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 $62.
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 Cass County Memorial 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.