CMS Price Transparency Data

Blood test, lipase

Facility: St Joseph's Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $120
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 17.42x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at St Joseph's Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 17.42x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

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: $135 (1959%)
Insurance Median: $120 (1742%)
Cash: $135 (1959% of Medicare)
Ins. Median: $120 (1742% 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 1742% of the Medicare baseline (a markup of 1642%). 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 $9 131%
Molina Healthcare $9 - $38 131%
Caterpillar, Inc. $14 203%
UnitedHealthcare $14 - $188 203%
Cigna $17 247%
Clear Spring Health of Illinois $38 552%
Humana $38 552%
Aetna $38 - $131 552%
Sae Hospice $38 552%
Blue Cross Blue Shield $38 552%
Amish Community $53 769%
Naphcare $79 1147%
Celtic Insurance Company $83 1205%
Hopetrust $94 1364%
Claim Doc $94 1364%
Wellfirst $120 1742%
First Health $139 2017%
Healthlink $160 2322%
Multiplan/Phcs $160 2322%
Provider Network of America $169 2453%
Healthcare Finest Network (Hfn) $169 2453%
Interplan $188 2729%
Qtc Medical Group of Illinois $188 2729%
Consociate Group $188 2729%
Current Health Solutions $188 2729%
Mental Health Network $188 2729%
Health Alliance Medical Plans $188 2729%
Healthscope $188 2729%
Illinois Breast and Cervical Cancer Program $188 2729%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals