CMS Price Transparency Data

Blood test, lipase

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $82
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 11.90x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Saint Joseph Regional Medical Center - Plymouth is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 11.90x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$82

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: $109 (1582%)
Insurance Median: $82 (1190%)
Cash: $109 (1582% of Medicare)
Ins. Median: $82 (1190% 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 1190% of the Medicare baseline (a markup of 1090%). 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 - $82 58%
Blue Cross Blue Shield $4 - $14 58%
Medicaid / KanCare $4 - $7 58%
UnitedHealthcare $4 - $106 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 - $139 145%
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 - $117 174%
Allied Benefit Systems $13 - $109 189%
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%
Plain Church Group $45 653%
Asr Health Benefits $82 1190%
Christian Brother Services $82 1190%
Employee Benefit Management $82 1190%
Medical Mutual $82 1190%
Meritain $82 1190%
Preferred One $82 1190%
Rural Carrier Health Benefit Plan $82 1190%
Webtpa $82 1190%
Notre Dame Athletic Association $92 1335%
Wc Notre Dame $92 1335%
Luminare Health (Detroit) $95 - $100 1379%
Ameriben $100 1451%
Geha $106 1538%
Healthscope $106 1538%
Student Insurance Cma $106 1538%
Encore Health $117 1698%
Indiana Criminal Justice Inst $117 1698%
Western & Southern Financial Group $117 1698%
Cigna $120 1742%
Group Administrators $120 1742%
Health Partners $120 1742%
Mvp $120 1742%
Prairie States $120 1742%
Priority Health $120 1742%
Professional Benefit Administrators $120 1742%
Sagamore Health Network $120 - $129 1742%
Sisco Benefits $120 1742%
Unified Group Services $120 1742%
Goshen Preferred Network $129 - $144 1872%
Signature Care $139 2017%
Allied National Global Care $150 2177%
Asrm - Reliance Standard Life Insurance $150 2177%
Avmed Health Plan $150 2177%
Christian Care Ministry $150 2177%
Dean Health $150 2177%
Fallon Health $150 2177%
Family Life Insurance Company $150 2177%
Freedom Life Insurance Company $150 2177%
Ghc Scw $150 2177%
International Benefit Administrators $150 2177%
Lifetime Benefit Solutions $150 2177%
Manhattan Life $150 2177%
Medi Share $150 2177%
Multiplan $150 2177%
Pai $150 2177%
Pan-American Life $150 2177%
Paramount Hmo $150 2177%
Phcs $150 2177%
Philadelphia American Life Insurance $150 2177%
Trinity Health Share $150 2177%
Bankers Life Casualty $167 2424%
Bureau Of Disability $167 2424%
Wc Align Network $167 2424%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals