CMS Price Transparency Data

Blood test, lipase

Facility: Wabash General Hospital 1

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $183
Cash Discount Price: $244
vs. Medicare Baseline: 26.56x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Wabash General Hospital 1 is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 26.56x the Medicare baseline. Located in 1418 College Drive, Mount Carmel, IL.

Cash / Self-Pay

$244

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

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: $244 (3541%)

Insurance Median: $183 (2656%)

Cash: $244 (3541% of Medicare)

Ins. Median: $183 (2656% 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 2656% of the Medicare baseline (a markup of 2556%). 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	$11 - $207	160%
Blue Cross Blue Shield	$11 - $212	160%
Meridian Mcaid - All Plans	$11	160%
Molina Mcaid - All Plans	$11	160%
UnitedHealthcare	$47 - $76	682%
Health Alliance Mcr Adv - All Plans	$77	1118%
Healthlink Hmo	$171	2482%
Cigna	$183	2656%
Encore Combined Ip/Op Only	$183	2656%
Hope Trust - All Plans	$183	2656%
Healthlink Ppo - All Other Plans	$195	2830%
Phcs - All Plans	$195	2830%
Health Smart - All Plans	$207	3004%
Hfn - All Plans	$207	3004%
Multiplan - All Plans	$207	3004%
Siho Network - All Plans	$207	3004%
Encore Health Network Ip/Op Only - All Other Plans	$220	3193%

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 $244.
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 Wabash General Hospital 1 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.