CMS Price Transparency Data
Blood test, lipase
Facility: Trinity Health Oakland Hospital
Billing Code: 83690 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83690
- Insurance Median: $22
- Cash Discount Price: $25
- vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Trinity Health Oakland Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.19x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$25
Average discount available for prompt cash payment at this facility.
Insurance Median
$22
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: $25 (363%)
Insurance Median: $22 (319%)
Cash: $25 (363% of Medicare)
Ins. Median: $22 (319% 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 319% of the Medicare baseline (a markup of 219%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Wc Accident Fund | $3 - $22 | 44% |
| Wc Advantage | $3 - $22 | 44% |
| Wc Aig | $3 - $22 | 44% |
| Wc Allied | $3 - $22 | 44% |
| Wc Amerisure | $3 - $22 | 44% |
| Wc Amtrust | $3 - $22 | 44% |
| Wc Asu Risk Mgt | $3 - $22 | 44% |
| Wc Berkley Admin | $3 - $22 | 44% |
| Wc Broadspire | $3 - $22 | 44% |
| Wc Bunch & Associates | $3 - $22 | 44% |
| Wc Ccmsi | $3 - $22 | 44% |
| Wc Emc Insurance Company | $3 - $22 | 44% |
| Wc Esis | $3 - $22 | 44% |
| Wc Fcci | $3 - $22 | 44% |
| Wc Federated | $3 - $22 | 44% |
| Wc Gallagher Bassett | $3 - $22 | 44% |
| Wc Genex Care For Ohio | $3 - $22 | 44% |
| Wc Guard Insurance Company | $3 - $22 | 44% |
| Wc Hartford | $3 - $22 | 44% |
| Wc Liberty Mutual | $3 - $22 | 44% |
| Wc Meijers | $3 - $22 | 44% |
| Wc Michigan | $3 - $22 | 44% |
| Wc Mitchell Frankenmuth | $3 - $22 | 44% |
| Wc Pma | $3 - $22 | 44% |
| Wc Sedgwick | $3 - $22 | 44% |
| Wc Sentry | $3 - $22 | 44% |
| Wc Travelers | $3 - $22 | 44% |
| Wc Tristar | $3 - $22 | 44% |
| Wc Walmart | $3 - $22 | 44% |
| Wc Zurich | $3 - $22 | 44% |
| Aetna | $4 - $33 | 58% |
| Blue Cross Blue Shield | $4 - $7 | 58% |
| Medicaid / KanCare | $4 | 58% |
| Acs Benefit Services | $5 - $32 | 73% |
| Allied Benefit Systems | $5 - $32 | 73% |
| Claimchoice Adminstrators | $5 - $32 | 73% |
| Consociate | $5 - $32 | 73% |
| Cypress Benefit Administrators | $5 - $32 | 73% |
| Forest County Potawatomi | $5 - $32 | 73% |
| Health Smart | $5 - $32 | 73% |
| Healthgram | $5 - $32 | 73% |
| Healthscope | $5 - $32 | 73% |
| Mclaren Health | $5 - $38 | 73% |
| Secureone Preferred United Plans | $5 - $32 | 73% |
| Sisco Benefits | $5 - $32 | 73% |
| The Health Plan | $5 - $32 | 73% |
| Trustmark Small Business Benefits | $5 - $32 | 73% |
| Unified Group Services | $5 - $32 | 73% |
| Webtpa | $5 - $32 | 73% |
| Carelon Behavioral Health | $6 - $36 | 87% |
| Align Senior Care | $7 | 102% |
| Bcn Domestic | $7 | 102% |
| Blue Benefit Administrators Of Massachusetts | $7 | 102% |
| Blue Care Network | $7 | 102% |
| Blue Care Network Advantage | $7 | 102% |
| Blue Distinction Transplant | $7 | 102% |
| Blue Shield - Ca | $7 | 102% |
| Blue Shield - Id (Regence) | $7 | 102% |
| Blue Shield - Ny Highmark Northeastern | $7 | 102% |
| Blue Shield - Ny Highmark Western | $7 | 102% |
| Blue Shield - Pa (Highmark) | $7 | 102% |
| Blue Shield - Wa (Regence) | $7 | 102% |
| Cca - Zing Health | $7 | 102% |
| Health Choices | $7 - $53 | 102% |
| Hospice Advantage | $7 | 102% |
| Kaiser Domestic | $7 | 102% |
| Magellan Behavioral Health | $7 - $43 | 102% |
| Medicare (plans) | $7 | 102% |
| UnitedHealthcare | $7 - $54 | 102% |
| 1199 National Benefit Fund | $8 - $49 | 116% |
| Access Health | $8 - $53 | 116% |
| Acclaim | $8 - $53 | 116% |
| Administrative Concepts | $8 - $53 | 116% |
| Allegeant | $8 - $53 | 116% |
| Allied National Global Care | $8 - $49 | 116% |
| Ameriben | $8 - $53 | 116% |
| American Family | $8 - $53 | 116% |
| American Healthcare Alliance | $8 - $53 | 116% |
| American National | $8 - $53 | 116% |
| American Republic | $8 - $53 | 116% |
| Amerihealth | $8 - $53 | 116% |
| Asrm - Reliance Standard Life Insurance | $8 - $49 | 116% |
| Aultcare | $8 - $53 | 116% |
| Automated Benefit Services | $8 - $53 | 116% |
| Auxiant | $8 - $53 | 116% |
| Benefit Administrative Systems,Llc | $8 - $53 | 116% |
| Boon Chapman | $8 - $53 | 116% |
| Cam Administrative Services | $8 - $53 | 116% |
| Christian Brother Services | $8 - $53 | 116% |
| Christian Brothers Holy Cross | $8 - $53 | 116% |
| Christian Care Ministry | $8 - $49 | 116% |
| Cigna | $8 - $53 | 116% |
| Comprehensive Benefits | $8 - $53 | 116% |
| Continental Life Insurance | $8 - $53 | 116% |
| Custom Benefit Administrators | $8 - $53 | 116% |
| Dean Health | $8 - $49 | 116% |
| Employee Benefit Concepts | $8 - $53 | 116% |
| Employee Benefit Management | $8 - $53 | 116% |
| Enterprise Group Planning | $8 - $53 | 116% |
| Fallon Health | $8 - $49 | 116% |
| Family Life Insurance Company | $8 - $49 | 116% |
| Freedom Life Insurance Company | $8 - $53 | 116% |
| Ghc Scw | $8 - $49 | 116% |
| Group Administrators | $8 - $53 | 116% |
| Group Marketing Services | $8 - $53 | 116% |
| Group Pension Administrators | $8 - $49 | 116% |
| Guardian | $8 - $53 | 116% |
| Hap | $8 - $52 | 116% |
| Health America | $8 - $53 | 116% |
| Health Partners | $8 - $52 | 116% |
| Healthcare Management Admin | $8 - $53 | 116% |
| Healthez | $8 - $53 | 116% |
| Humana | $8 - $53 | 116% |
| Insight | $8 - $53 | 116% |
| Intercare | $8 - $53 | 116% |
| International Benefit Administrators | $8 - $49 | 116% |
| Jfp Benefit Management | $8 - $53 | 116% |
| Jp Farley Corporation | $8 - $53 | 116% |
| Key Benefit Administrator | $8 - $53 | 116% |
| Liberty Union Life Assurance Co | $8 - $53 | 116% |
| Lifetime Benefit Solutions | $8 - $49 | 116% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $8 | 116% |
| Lucent Health | $8 - $53 | 116% |
| Luminare Health | $8 - $53 | 116% |
| Luminare Health (Detroit) | $8 - $53 | 116% |
| Magnacare | $8 - $53 | 116% |
| Manhattan Life | $8 - $49 | 116% |
| Medben | $8 - $53 | 116% |
| Medcost | $8 - $53 | 116% |
| Medi Share | $8 - $49 | 116% |
| Multiplan | $8 - $49 | 116% |
| Mutual Health Services | $8 - $53 | 116% |
| Mutual Of Omaha | $8 - $53 | 116% |
| Mvp | $8 - $49 | 116% |
| Ncas | $8 - $53 | 116% |
| Nippon Life Ins | $8 - $53 | 116% |
| Nova | $8 - $53 | 116% |
| Pai | $8 - $49 | 116% |
| Painters Union Insurance Fund | $8 - $53 | 116% |
| Pan-American Life | $8 - $49 | 116% |
| Paramount Hmo | $8 - $49 | 116% |
| Phcs | $8 - $49 | 116% |
| Physicians Mutual | $8 - $53 | 116% |
| Plumbers Local 98 Insurance Fund | $8 - $53 | 116% |
| Prairie States | $8 - $53 | 116% |
| Preferred One | $8 - $53 | 116% |
| Primary Physician Care | $8 - $53 | 116% |
| Professional Benefit Administrators | $8 - $53 | 116% |
| Siho Insurance Services | $8 - $53 | 116% |
| The Loomis Company | $8 - $53 | 116% |
| Trinity Health Share | $8 - $49 | 116% |
| Tufts Health Plan | $8 - $52 | 116% |
| U Of M Health Plan | $8 | 116% |
| Unicare | $8 - $53 | 116% |
| Us Health And Life | $8 - $53 | 116% |
| Valenz | $8 - $53 | 116% |
| Western & Southern Financial Group | $8 - $53 | 116% |
| Wps | $8 - $53 | 116% |
| Coventry | $9 - $54 | 131% |
| First Health | $9 - $54 | 131% |
| Geha | $9 - $54 | 131% |
| Molina Marketplace | $9 | 131% |
| Prime Health Services | $9 - $58 | 131% |
| Medical Mutual | $10 | 145% |
| Meritain | $10 | 145% |
| Priority Health | $10 - $11 | 145% |
| Three Rivers Provider Network | $10 - $65 | 145% |
| Cmh Detroit Wayne Integrated Health Network | $11 - $72 | 160% |
| Cmh Lenawee County | $11 - $72 | 160% |
| Cmh Livingston County | $11 - $72 | 160% |
| Cmh Misc | $11 - $72 | 160% |
| Cmh Monroe County | $11 - $72 | 160% |
| Cmh Oakland County | $11 - $72 | 160% |
| Cmh Washtenaw County | $11 - $72 | 160% |
| Health Cost Solutions | $11 | 160% |
| Vitalcore | $11 | 160% |
| Wellpath | $11 | 160% |
| Employee Benefit Logistic | $16 | 232% |
| Asr Health Benefits | $23 | 334% |
| Caresource | $23 | 334% |
| Varipro | $23 | 334% |