CMS Price Transparency Data

Blood test, lipase

Facility: Mt Sinai Hospital Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $28
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 4.06x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mt Sinai Hospital Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 4.06x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $42 (610%)
Insurance Median: $28 (406%)
Cash: $42 (610% of Medicare)
Ins. Median: $28 (406% 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 406% of the Medicare baseline (a markup of 306%). 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
Oscar - All Plans $2 - $66 29%
Blue Cross Blue Shield $6 - $87 87%
Cigna $6 - $168 87%
Advocate Physician Prtnrs Mcr $7 102%
Aetna $7 - $308 102%
Cenpatico Illinicare Dual $7 102%
Cenpatico Illinicare Mcr - All Other Plans $7 102%
Family Health Network Mcaid - All Plans $7 102%
Harmony Behavioral Htlh - All Plans $7 102%
Humana $7 - $427 102%
Lawndale Christian - All Plans $7 - $27 102%
Meridian/Harmony D-Snp - All Plans $7 102%
Molina Mcr - All Other Plans $7 102%
Nextlevel Hlth Icp Fhp Aca - All Plans $7 102%
Tricare $7 102%
UnitedHealthcare $7 102%
Va Healthnet - All Plans $7 102%
Zing Mcr Adv - All Plans $7 102%
Advocate Physician Prtnrs - All Other Plans $8 116%
Ambetter / Centene $8 - $143 116%
Molina Mcaid $8 116%
Partners In Hlth - All Plans $14 - $54 203%
Healthlink Hmo $17 - $68 247%
Healthlink Ppo - All Other Plans $17 - $68 247%
Compsych Ip/Op Only - All Plans $21 - $82 305%
Hfn Platinum $23 - $88 334%
Multiplan Primary Ntwrk/Phcs - All Other Plans $24 - $95 348%
Hfn Epo $28 - $109 406%
Multiplan Complementary Ntwrk $28 - $109 406%
Hfn Ppo - All Other Plans $31 - $120 450%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals