CMS Price Transparency Data

Blood test, lipase

Facility: Mc Donough District Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $48
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 6.97x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mc Donough District Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.97x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $35 (508%)
Insurance Median: $48 (697%)
Cash: $35 (508% of Medicare)
Ins. Median: $48 (697% 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 697% of the Medicare baseline (a markup of 597%). 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
Health Alliance $4 - $52 58%
Aetna $6 - $58 87%
Blue Cross Blue Shield $6 - $58 87%
Hfn $6 - $52 87%
Humana $6 - $52 87%
Medicaid / KanCare $6 - $58 87%
UnitedHealthcare $6 - $52 87%
Medicare (plans) $7 102%
Meridian $7 102%
Molina $7 - $58 102%
Mutual Medical $7 - $58 102%
Tricare $7 102%
Veteran Affairs $7 102%
Springfield Health $48 697%
Consociate $49 711%
Trilogy $49 711%
Blue Choice $52 755%
Current Health $52 755%
Healthlink $52 - $55 755%
Preferred Plan $55 798%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals