CMS Price Transparency Data

Blood test, lipase

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $12
Cash Discount Price: $79
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at UMass Memorial Health - Harrington Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.74x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $79 (1147%)

Insurance Median: $12 (174%)

Cash: $79 (1147% of Medicare)

Ins. Median: $12 (174% 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.

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
Masshealth [20302]	$6	87%
Medicaid / KanCare	$6 - $7	87%
Aetna	$7 - $79	102%
Blue Cross Blue Shield	$7 - $22	102%
Cigna	$7 - $56	102%
Commonwealth Care Alliance [10103]	$7	102%
Fallon Mcr Supp [20202]	$7	102%
Fallon Mcr [10105]	$7	102%
Institution [10406]	$7	102%
Mgb Mcr [10124]	$7	102%
Senior Whole Health [10110]	$7	102%
Tufts Mcr [10112]	$7	102%
Tufts Us Family [11203]	$7	102%
UnitedHealthcare	$7 - $79	102%
Champva [11001]	$8	116%
Workers Compensation [20501]	$10	145%
Tufts Connectorcare [10507]	$12	174%
Wellpoint [11112]	$18	261%
Harvard Pilgrim [10701]	$26 - $31	377%
Fallon Connectorcare [10503]	$38	552%
Hne [11108]	$51	740%
Tufts [11201]	$56	813%
First Health Network [11120]	$59	856%
Evernorth Behavioral Health [27]	$63	914%
Connecticare [11105]	$79	1147%
Fallon Carelon Hlth [28]	$79	1147%
Fallon Mcaid Carelon Hlth [29]	$79	1147%
Grants [20507]	$79	1147%
Masshealth Mcd Mbhp [38]	$79	1147%
Wellsense Mcaid Carelon Hlth [21]	$79	1147%
Hsno/Free Care [10801]	$681	9884%

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 $79.
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 UMass Memorial Health - Harrington 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.