CMS Price Transparency Data

Blood test, lipase

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $9
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at St Anthony Regional Hospital & Nursing Home is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.31x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $16 (232%)
Insurance Median: $9 (131%)
Cash: $16 (232% of Medicare)
Ins. Median: $9 (131% 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.

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 $1 - $17 15%
Va Ccn - All Plans $1 15%
Medica Mcr - All Plans $4 - $8 58%
Wellpoint Mcr Adv $4 - $8 58%
Ia Total Care Mcaid $5 - $9 73%
Wellpoint Mcaid - All Other Plans $5 - $9 73%
Aetna $8 - $19 116%
Humana $8 - $18 116%
Ia Total Care Mcr $8 116%
Molina Mcaid - All Plans $9 131%
Ia Total Care Comm - All Other Plans $10 145%
Midlands Choice - All Plans $20 290%
Wellmark Hmo $20 290%
Wellmark Ppo-All Other Plans $23 334%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 311 South Clark Street, Carroll, IA 51401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals