CMS Price Transparency Data

Blood test, lipase

Facility: Nell J Redfield Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $44
Cash Discount Price: $72
vs. Medicare Baseline: 6.39x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Nell J Redfield Memorial Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.39x the Medicare baseline. Located in 150 North 200 West, Malad City, ID.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $72 (1045%)

Insurance Median: $44 (639%)

Cash: $72 (1045% of Medicare)

Ins. Median: $44 (639% 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 639% of the Medicare baseline (a markup of 539%). 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
Regence Bs Comm - All Other Plans	$6	87%
UnitedHealthcare	$6 - $72	87%
Bc Comm - All Other Plans	$37	537%
Regence Bs Mcr	$42	610%
Aetna	$43 - $70	624%
Bc Mcr Adv	$43	624%
Choicecare Mcr Adv	$43	624%
Pacificsource Mcr Adv - All Plans	$44	639%
University Of Ut - All Plans	$68	987%
Choicecare Ppo - All Other Plans	$72	1045%
Town & Country - All Plans	$72	1045%
Brightpath Select Hlth - All Plans	$76	1103%

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 $72.
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 Nell J Redfield 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.