CMS Price Transparency Data

Blood test, lipase

Facility: Warner Hospital and Health Services

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $17
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Warner Hospital and Health Services is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.47x the Medicare baseline. Located in 422 W White St, Clinton, IL.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $84 (1219%)
Insurance Median: $17 (247%)
Cash: $84 (1219% of Medicare)
Ins. Median: $17 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
Aetna $4 - $135 58%
Blue Cross Blue Shield $4 - $156 58%
Health Alliance Med Adv $4 - $65 58%
Humana $4 - $135 58%
Molina Mcr/Mcd Dual $4 - $65 58%
UnitedHealthcare $4 - $135 58%
Wellcare Mcr Adv-All Plans $4 - $65 58%
City Of Clinton (Employees Serv)-All Plans $7 - $127 102%
Healthlink Hmo $7 - $124 102%
Caterpillar-All Plans $8 - $135 116%
Cigna $8 - $132 116%
Consociate Care Ppo-All Plans $8 - $143 116%
Health Alliance-All Other Plans $8 - $140 116%
Healthlink Ppo/Work Comp-All Other Plans $8 - $140 116%
Hfn Ppo/Epo-All Plans $8 - $143 116%
Multiplan Phcs-All Plans $8 - $135 116%
Three Rivers-All Plans $9 - $151 131%
Harmony Hp Mcaid-All Plans $17 247%
Medicaid / KanCare $17 247%
Meridian Hp-All Plans $17 247%
Molina-All Other Plans $17 247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 422 W White St, Clinton, IL 61727
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals