CMS Price Transparency Data

Blood test, lipase

Facility: Memorial Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $169
Cash Discount Price: $282
vs. Medicare Baseline: 24.53x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Memorial Medical Center is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $282. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 24.53x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$282

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $282 (4093%)

Insurance Median: $169 (2453%)

Cash: $282 (4093% of Medicare)

Ins. Median: $169 (2453% 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 2453% of the Medicare baseline (a markup of 2353%). 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
Health Alliance	$3 - $183	44%
Veterans Administration	$5	73%
Blue Cross Blue Shield	$6 - $282	87%
Medicaid / KanCare	$6	87%
Molina	$6	87%
Aetna	$7 - $214	102%
Humana	$7 - $169	102%
Medicare (plans)	$7 - $282	102%
Tricare	$7	102%
UnitedHealthcare	$7 - $175	102%
Healthlink	$24 - $178	348%
Commercial Workers Compensation	$89	1292%
Illinois Workers Compensation	$94	1364%
Current Health Network Ppo	$127	1843%
Cigna	$148	2148%
Phcs/Multiplan	$152 - $169	2206%
6 Degrees Health	$169	2453%
Hopetrust	$169	2453%
Hst	$169	2453%
Magellan	$169	2453%
Consociate	$183	2656%
Hfn	$183	2656%
Preferred Plan	$212	3077%
Soi Mcfarland	$212	3077%
Soi Rushville	$212	3077%
Corvel	$226	3280%
Methodist First Choice	$226	3280%
Mutual Medical Plans	$240	3483%
Liability	$282	4093%

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 $282.
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 Memorial Medical Center 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.