CMS Price Transparency Data

Blood test, lipase

Facility: Northwest Health - Porter

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $17
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Northwest Health - Porter is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.47x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$79

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: $79 (1147%)
Insurance Median: $17 (247%)
Cash: $79 (1147% 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
Blue Cross Blue Shield $3 - $10 44%
Tricare $6 87%
UnitedHealthcare $6 - $39 87%
Aetna $7 - $128 102%
Care Improvement Plus $7 102%
Caresource $7 102%
Healthy Indiana Plan $7 102%
Humana $7 102%
In Dept Of Correction $7 102%
Managed Health Services $7 - $14 102%
Medicaid / KanCare $7 102%
Medicare (plans) $7 102%
Mhs $7 102%
Node Devoted Health Mcr Adv $7 102%
Node Hospice Non Par Agree $7 102%
Node Mhs Mcr Adv $7 102%
Node Va $7 102%
Veterans Eval Services $7 102%
Node Us Dept Of Labor $9 131%
Align Network $11 160%
One Call Work Comp $11 160%
Encore Health $12 - $202 174%
Prime Health $12 - $189 174%
Indiana Work Comp $14 203%
Lutheran Preferred $14 - $151 203%
Node Encore Kba Epo $17 247%
Porter County $17 247%
Preferred Network Access $17 247%
Magnacare Ma $18 261%
Lutheran Preferred Chs Employees $60 871%
Self Pay $68 - $91 987%
Cigna $70 1016%
Physicians Health Plan $97 1408%
Php Freedom $104 1509%
Sagamore Health Network $111 - $149 1611%
First Health Coventry $123 1785%
Encore Ppo $126 1829%
Southeastem Indiana Health Operations $176 - $189 2554%
Network Synergy Group $189 2743%
Multiplan/Phcs $212 3077%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals