CMS Price Transparency Data

Blood test, lipase

Facility: Pulaski Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $66
Cash Discount Price: $142
vs. Medicare Baseline: 9.58x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Pulaski Memorial Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.58x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $142 (2061%)

Insurance Median: $66 (958%)

Cash: $142 (2061% of Medicare)

Ins. Median: $66 (958% 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 958% of the Medicare baseline (a markup of 858%). 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
Blue Cross Blue Shield	$7 - $135	102%
Caresource Mcaid Hhw	$7	102%
Cenpatico Mcaid Hhw - All Other Plans	$7	102%
Mdwise Mcaid Hcc	$7	102%
Mdwise Mcaid Hhw	$7	102%
Mhs Mcaid Hhw/Hcc	$7	102%
UnitedHealthcare	$7 - $160	102%
Ambetter / Centene	$63	914%
Caresource Mcaid Hip	$63	914%
Caresource Mcare Hmo	$63	914%
Cenpatico Mcaid Hip	$63	914%
Mdwise Mcaid Hip - All Other Plans	$63	914%
Mhs Mcaid Hip	$63	914%
Humana	$64 - $163	929%
Mhs Mcare Allwell	$64	929%
Aetna	$73	1060%
Caresource Exch Hmo Hix - All Other Plans	$79	1147%
Sagamore Rose Acre	$151	2192%
Sagamore - All Other Plans	$153	2221%
Encore Ppo - All Other Plans	$173	2511%
Community Health Alliance - All Plans	$181	2627%
Encore Workers Comp	$183	2656%
Multiplan - All Plans	$183	2656%
Cigna	$193	2801%

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 $142.
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 Pulaski 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.