CMS Price Transparency Data

Blood test, lipase

Facility: HSHS St Elizabeth's Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $104
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 15.09x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at HSHS St Elizabeth's Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.09x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $94 (1364%)
Insurance Median: $104 (1509%)
Cash: $94 (1364% of Medicare)
Ins. Median: $104 (1509% 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 1509% of the Medicare baseline (a markup of 1409%). 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
Meridian Health Plan $4 58%
Molina Healthcare $4 - $7 58%
Aetna $7 - $92 102%
Blue Cross Blue Shield $7 - $131 102%
Clear Spring Health Of Illinois $7 102%
Health Alliance Medical Plans $7 - $111 102%
Health Partners $7 102%
Humana $7 102%
Sae Hospice $7 102%
UnitedHealthcare $7 - $131 102%
Celtic Insurance Company $15 218%
Naphcare $16 232%
Claim Doc $17 247%
Hopetrust $17 247%
Amish Community $37 537%
Wellfirst $84 1219%
First Health $97 1408%
Cigna $103 - $131 1495%
Healthlink $104 - $131 1509%
Caterpillar, Inc. $105 1524%
Consociate Group $115 1669%
Choicecare $118 1713%
Healthcare Finest Network (Hfn) $118 1713%
Multiplan/Phcs $118 1713%
Provider Network Of America $118 1713%
City Of Springfield $131 1901%
Current Health Solutions $131 1901%
Healthscope $131 1901%
Illinois Breast And Cervical Cancer Program $131 1901%
Interplan $131 1901%
Live360 $131 1901%
Wexford $131 1901%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals