CMS Price Transparency Data

Blood test, lipase

Facility: Saint Joseph Regional Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $42
  • Cash Discount Price: $103
  • vs. Medicare Baseline: 6.10x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Saint Joseph Regional Medical Center is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 6.10x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$103

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $103 (1495%)
Insurance Median: $42 (610%)
Cash: $103 (1495% of Medicare)
Ins. Median: $42 (610% 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 610% of the Medicare baseline (a markup of 510%). 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 - $78 58%
Blue Cross Blue Shield $4 - $14 58%
Medicaid / KanCare $4 - $7 58%
UnitedHealthcare $4 - $101 58%
County Coroner $7 102%
Managed Health Services - Indiana $7 102%
Mdwise $7 102%
Medicare (plans) $7 102%
Meridian Complete $7 102%
Pace-Trinity Health $7 102%
Provider Partners Health Plan Of Indiana $8 116%
Auxiant $10 - $132 145%
Physicians Health Plan Northern Indiana Health Insurance $10 - $21 145%
St Joseph County Hlth Dpt $10 145%
Caresource $11 160%
Siho Insurance Services $11 160%
Key Benefit Administrator $12 - $99 174%
Allied Benefit Systems $13 - $103 189%
Blue Benefit Administrators Of Massachusetts $14 203%
Blue Care Network $14 203%
Blue Distinction Transplant $14 203%
Blue Shield - Ca $14 203%
Blue Shield - Id (Regence) $14 203%
Blue Shield - Ny Highmark Northeastern $14 203%
Blue Shield - Ny Highmark Western $14 203%
Blue Shield - Pa (Highmark) $14 203%
Blue Shield - Wa (Regence) $14 203%
Custom Design Benefits $15 218%
Hospice Of Marshall County $41 595%
Hospice Of St Joseph County $41 595%
Plain Church Group $43 624%
Asr Health Benefits $78 1132%
Christian Brother Services $78 1132%
Employee Benefit Management $78 1132%
Medical Mutual $78 1132%
Meritain $78 1132%
Preferred One $78 1132%
Rural Carrier Health Benefit Plan $78 1132%
Webtpa $78 1132%
Notre Dame Athletic Association $87 1263%
Wc Notre Dame $87 1263%
Luminare Health (Detroit) $91 - $95 1321%
Encore Health $94 - $99 1364%
Ameriben $95 1379%
Indiana Criminal Justice Inst $99 1437%
Western & Southern Financial Group $99 1437%
Geha $101 1466%
Healthscope $101 1466%
Student Insurance Cma $101 1466%
Cigna $102 1480%
Group Administrators $102 1480%
Health Partners $102 1480%
Mvp $102 1480%
Prairie States $102 1480%
Priority Health $102 1480%
Professional Benefit Administrators $102 1480%
Sagamore Health Network $102 - $118 1480%
Sisco Benefits $102 1480%
Unified Group Services $102 1480%
Goshen Preferred Network $122 - $137 1771%
Christian Brothers Holy Cross $127 1843%
Signature Care $127 1843%
Bankers Life Casualty $159 2308%
Bureau Of Disability $159 2308%
Wc Align Network $159 2308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals