CMS Price Transparency Data

Blood test, lipase

Facility: Fhn Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $135
Cash Discount Price: $156
vs. Medicare Baseline: 19.59x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Fhn Memorial Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 19.59x the Medicare baseline. Located in 1045 West Stephenson Street, Freeport, IL.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

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: $156 (2264%)

Insurance Median: $135 (1959%)

Cash: $156 (2264% of Medicare)

Ins. Median: $135 (1959% 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 1959% of the Medicare baseline (a markup of 1859%). 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
Meridian Health Plan - All Plans	$4	58%
Aetna	$7 - $108	102%
Health Alliance Mcr Adv	$7	102%
Humana	$7 - $154	102%
Quartz Mcr Adv	$7	102%
UnitedHealthcare	$7 - $152	102%
The Alliance - All Plans	$117	1698%
Ecoh Nihp	$123	1785%
Nihp Employ - All Plans	$123	1785%
Quartz - All Other Plans	$126	1829%
Blue Cross Blue Shield	$131	1901%
Ecoh - All Other Plans	$132	1916%
Northern Il Hp - All Plans	$134	1945%
First Health - All Plans	$137	1988%
Hfn - All Plans	$159	2308%
First Choice Il - All Plans	$165	2395%
Multiplan Phcs - All Plans	$165	2395%
Wps - All Plans	$170	2467%
Galaxy - All Plans	$175	2540%
Health Alliance - All Other Plans	$175	2540%
Interplan Health - All Plans	$175	2540%
Preferred Plan Ppo - All Plans	$175	2540%
Trustmark - All Plans	$179	2598%
Midland Choice - All Plans	$185	2685%
Osf Healthplans - All Plans	$194	2816%

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 $156.
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 Fhn 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.