CMS Price Transparency Data

Blood test, lipase

Facility: Woodlawn Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $39
Cash Discount Price: $133
vs. Medicare Baseline: 5.66x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Woodlawn Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.66x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$133

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $133 (1930%)

Insurance Median: $39 (566%)

Cash: $133 (1930% of Medicare)

Ins. Median: $39 (566% 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 566% of the Medicare baseline (a markup of 466%). 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	$3 - $135	44%
Mdwise Excel Hhw & Hcc	$5	73%
Caresource Mcaid Hww	$7	102%
Mhs Mcaid Hcc	$7	102%
Mhs Mcaid Hhw	$7	102%
UnitedHealthcare	$7 - $135	102%
Partners Direct Health-All Plans	$12	174%
Aetna	$39 - $168	566%
Caresource Mcaid Hip	$39	566%
Caresource Mcr Adv	$39	566%
Humana	$39 - $137	566%
Mdwise Mcaid Excel Hip	$39	566%
Mhs Exch Mrktplce-All Other Plans	$39	566%
Mhs Mcaid Hip	$39	566%
Mhs Mcr Adv	$40	581%
Caresource Exch - All Other Plans	$51	740%
Ambetter / Centene	$52	755%
Cigna	$127 - $150	1843%
Parkview Health Plans-All Plans	$133	1930%
Sagamore All Other Grps - All Other Plans	$149	2163%
Encore Comm-All Plans	$150	2177%
Phcs/Multiplan-All Plans	$165	2395%
Community Health Alliance-All Plans	$168	2438%

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 $133.
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 Woodlawn 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.