CMS Price Transparency Data

Blood test, lipase

Facility: North Adams Regional Hospital Corporation

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $37
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at North Adams Regional Hospital Corporation is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.37x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $60 (871%)
Insurance Median: $37 (537%)
Cash: $60 (871% of Medicare)
Ins. Median: $37 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Mcd Masshealth $6 87%
Mcd New York $6 87%
Mcd Out Of State $6 87%
Mcdmanaged Bmchnp $6 - $7 87%
Mcdmanaged Cdphp $6 87%
Mcdmanaged Hne Mcdaco $6 87%
Medicaid / KanCare $6 - $28 87%
Comm Hospice $7 - $14 102%
Mcdmanaged Network $7 - $35 102%
Mcr Miscellaneous $7 - $14 102%
Mcrmanaged Usa Family $7 - $14 102%
Mcrmanaged Va $7 - $14 102%
Medicare (plans) $7 - $15 102%
Oth United Vaccn $7 - $14 102%
Aetna $8 - $47 116%
Blue Cross Blue Shield $8 - $53 116%
Mcrmanaged Cca One Care $8 - $14 116%
Tricare $8 - $24 116%
Comm Fallon Qhp $10 - $35 145%
Comm Unicare $18 - $41 261%
Comm Network Qhpsub $35 - $38 508%
Wc Workers Comp $38 552%
Comm Network Qhpnonsub $40 - $45 581%
Comm Hne Hmo $41 - $47 595%
Comm Nhp $41 595%
Comm Hne $42 - $44 610%
Comm Hne Ppo $44 - $47 639%
Comm Tufts $50 726%
UnitedHealthcare $54 784%
Cigna $56 - $58 813%
Comm Cdphp $56 813%
Comm Mvp $56 813%
Comm Oxford $56 813%
Comm First Health $58 - $60 842%
Comm Connecticare $60 871%
Comm Consolidated Health $60 871%
Comm Harvard $60 871%
Comm Other $60 871%
Comm Phcs $60 871%
Comm Self Pay $60 871%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals