CMS Price Transparency Data

Blood test, lipase

Facility: Rochelle Community Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $129
Cash Discount Price: $172
vs. Medicare Baseline: 18.72x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Rochelle Community Hospital is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 18.72x the Medicare baseline. Located in 900 N 2Nd St, Rochelle, IL.

Cash / Self-Pay

$172

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $172 (2496%)

Insurance Median: $129 (1872%)

Cash: $172 (2496% of Medicare)

Ins. Median: $129 (1872% 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 1872% of the Medicare baseline (a markup of 1772%). 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
Aetna	$8 - $60	116%
Blue Cross Blue Shield	$8 - $172	116%
Medicaid / KanCare	$8	116%
The Alliance-All Plans	$12	174%
Health Alliance Mcr Adv	$60	871%
Humana	$60 - $138	871%
UnitedHealthcare	$60 - $155	871%
Va Ccn - All Plans	$60	871%
Wellcare Mcr Adv - All Plans	$61	885%
Cigna	$129	1872%
Osf Dan Ppo - All Plans	$129	1872%
Beech Street-All Plans	$138	2003%
First Health - All Plans	$138	2003%
Health Alliance-All Other Plans	$138	2003%
Ecoh-All Plans	$146	2119%
Hfn-All Plans	$146	2119%
Quartz Health Solutions-All Plans	$151	2192%
Multiplan-All Plans	$162	2351%

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 $172.
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 Rochelle Community 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.