CMS Price Transparency Data

Blood test, lipase

Facility: Norton-King's Daughters' Health

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $87
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 12.63x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Norton-King's Daughters' Health is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 12.63x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $24 (348%)
Insurance Median: $87 (1263%)
Cash: $24 (348% of Medicare)
Ins. Median: $87 (1263% 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 1263% of the Medicare baseline (a markup of 1163%). 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 $5 - $98 73%
Blue Cross Blue Shield $7 - $21 102%
Humana $7 102%
Managed Health Services $7 - $11 102%
Managed Health Services Of Indiana $7 102%
Managed Health Services Of Kentucky $7 102%
Passport By Molina $7 102%
UnitedHealthcare $7 - $87 102%
Caresource Of Indiana $10 145%
Caresource Of Kentucky $10 145%
Custom Design Benefits $14 - $56 203%
Cigna $94 1364%
Encore $94 1364%
Quality Care Partners $99 1437%
Bluegrass $100 1451%
First Health $100 1451%
Healthlink $100 1451%
Vha/Tristate $100 1451%
Multiplan/Phcs $102 1480%
Indiana Health Network $105 1524%
Siho $105 1524%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals