CMS Price Transparency Data

Blood test, lipase

Facility: Rush Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $51
Cash Discount Price: $69
vs. Medicare Baseline: 7.40x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Rush Memorial Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 7.40x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $69 (1001%)

Insurance Median: $51 (740%)

Cash: $69 (1001% of Medicare)

Ins. Median: $51 (740% 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 740% of the Medicare baseline (a markup of 640%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Net	$17 - $37	247%
Aetna	$18 - $115	261%
Caresource Mcr Adv	$18 - $39	261%
Humana	$18 - $115	261%
My True Advantage - All Plans	$18 - $39	261%
UnitedHealthcare	$18 - $100	261%
Blue Cross Blue Shield	$19 - $92	276%
Today'S Option Mcr Adv-All Plans	$19 - $40	276%
Viant Beech St Mcr Adv	$19 - $40	276%
Caresource Marketplace-All Other Plans	$29 - $62	421%
Cigna	$47 - $100	682%
Phcs-All Plans	$47 - $100	682%
Consumers Life Ins-All Plans	$53 - $113	769%
Coventry/First Health-All Plans	$53 - $113	769%
Multiplan-All Plans	$54 - $116	784%
Sagamore-All Plans	$54 - $115	784%
Siho-All Plans	$54 - $115	784%
Community Health Alliance-All Plans	$55 - $118	798%
Encore Health Services-All Plans	$57 - $123	827%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $69.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83690.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Rush Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83690.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.