CMS Price Transparency Data

Blood test, lipase

Facility: Portneuf Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $232
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 33.67x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Portneuf Medical Center is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 33.67x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

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: $164 (2380%)
Insurance Median: $232 (3367%)
Cash: $164 (2380% of Medicare)
Ins. Median: $232 (3367% 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 3367% of the Medicare baseline (a markup of 3267%). 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
Aetna $56 - $232 813%
Healthscope Benefits [2290] $56 813%
UnitedHealthcare $56 - $247 813%
Black Lung [6055] $112 1626%
Employee Benefit Management Services [2445] $112 - $164 1626%
Healthcare Highways [2210] $112 - $260 1626%
Lucent Health [6000] $112 1626%
Moda Health [6100] $112 1626%
Oncology Patient Assistance Programs [2295] $112 1626%
Pending Ssi [1616] $112 1626%
Web Tpa [2115] $112 1626%
Pacific Source Health Plans [2850] $158 2293%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $164 2380%
Medishare Christian Care [1645] $164 2380%
Multiplan [1680] $184 - $260 2671%
Worker'S Comp [2125] $199 - $206 2888%
Cigna $202 2932%
Enablecomp [1350] $206 2990%
Transamerican Life [1990] $206 2990%
First Health [1375] $226 3280%
Mailhandlers [1595] $232 3367%
Selecthealth [3740] $232 - $247 3367%
Geha [1415] $247 3585%
Humana $247 3585%
Administrative Concepts [1005] $260 3774%
Healthfirst [2395] $260 3774%
Healthnet [1495] $260 3774%
Hometown Health [2155] $260 3774%
Mayo Clinic Health Solutions [2280] $260 3774%
Meritain Health [1655] $260 3774%
Mutual Of Omaha [1685] $260 3774%
National Association Of Letter Carriers [1695] $260 3774%
New Era Life Insurance Company [1705] $260 3774%
Pan American Life Insurance Co [1770] $260 3774%
Pba [1775] $260 3774%
Phcs [1780] $260 3774%
Planned Administrators Inc [2360] $260 3774%
Trustmark [2030] $260 3774%
Ut Id Teamsters [3760] $260 3774%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals