CMS Price Transparency Data
Blood test, lipase
Facility: Mercy Health Saint Mary's
Billing Code: 83690 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83690
- Insurance Median: $17
- Cash Discount Price: $16
- vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Health Saint Mary's is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.47x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$16
Average discount available for prompt cash payment at this facility.
Insurance Median
$17
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: $16 (232%)
Insurance Median: $17 (247%)
Cash: $16 (232% of Medicare)
Ins. Median: $17 (247% 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 247% of the Medicare baseline (a markup of 147%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $4 - $9 | 58% |
| Medicaid / KanCare | $4 | 58% |
| Access Health | $5 | 73% |
| Aetna | $5 - $33 | 73% |
| Nomi Health | $6 - $42 | 87% |
| Wc Accident Fund | $6 - $41 | 87% |
| Wc Advantage | $6 - $41 | 87% |
| Wc Aig | $6 - $41 | 87% |
| Wc Allied | $6 - $41 | 87% |
| Wc Amerisure | $6 - $41 | 87% |
| Wc Amtrust | $6 - $41 | 87% |
| Wc Asu Risk Mgt | $6 - $41 | 87% |
| Wc Berkley Admin | $6 - $41 | 87% |
| Wc Broadspire | $6 - $41 | 87% |
| Wc Bunch & Associates | $6 - $41 | 87% |
| Wc Ccmsi | $6 - $41 | 87% |
| Wc Emc Insurance Company | $6 - $41 | 87% |
| Wc Esis | $6 - $41 | 87% |
| Wc Fcci | $6 - $41 | 87% |
| Wc Federated | $6 - $41 | 87% |
| Wc Gallagher Bassett | $6 - $41 | 87% |
| Wc Genex Care For Ohio | $6 - $41 | 87% |
| Wc Guard Insurance Company | $6 - $41 | 87% |
| Wc Hartford | $6 - $41 | 87% |
| Wc Liberty Mutual | $6 - $41 | 87% |
| Wc Meijers | $6 - $41 | 87% |
| Wc Michigan | $6 - $41 | 87% |
| Wc Mitchell Frankenmuth | $6 - $41 | 87% |
| Wc Pma | $6 - $41 | 87% |
| Wc Sedgwick | $6 - $41 | 87% |
| Wc Sentry | $6 - $41 | 87% |
| Wc Travelers | $6 - $41 | 87% |
| Wc Tristar | $6 - $41 | 87% |
| Wc Walmart | $6 - $41 | 87% |
| Wc Zurich | $6 - $41 | 87% |
| Acs Benefit Services | $7 - $43 | 102% |
| Align Senior Care | $7 | 102% |
| Allied Benefit Systems | $7 - $43 | 102% |
| Asr Health Benefits | $7 - $48 | 102% |
| Blue Care Network Advantage | $7 | 102% |
| Caresource | $7 - $49 | 102% |
| Claimchoice Adminstrators | $7 - $43 | 102% |
| Consociate | $7 - $43 | 102% |
| Correctional Recovery | $7 | 102% |
| Cypress Benefit Administrators | $7 - $43 | 102% |
| Forest County Potawatomi | $7 - $43 | 102% |
| Hap | $7 - $58 | 102% |
| Health Smart | $7 - $43 | 102% |
| Healthgram | $7 - $43 | 102% |
| Healthscope | $7 - $43 | 102% |
| Hospice Faith | $7 | 102% |
| Hospice Of Holland | $7 | 102% |
| Medicare (plans) | $7 | 102% |
| Oscar | $7 | 102% |
| Secureone Preferred United Plans | $7 - $43 | 102% |
| Sisco Benefits | $7 - $43 | 102% |
| The Health Plan | $7 - $43 | 102% |
| Trustmark Small Business Benefits | $7 - $43 | 102% |
| Unified Group Services | $7 - $43 | 102% |
| UnitedHealthcare | $7 - $75 | 102% |
| Varipro | $7 - $49 | 102% |
| Webtpa | $7 - $43 | 102% |
| 1199 National Benefit Fund | $8 - $55 | 116% |
| Allied National Global Care | $8 - $55 | 116% |
| Asrm - Reliance Standard Life Insurance | $8 - $55 | 116% |
| Christian Care Ministry | $8 - $55 | 116% |
| Cigna | $8 - $55 | 116% |
| Dean Health | $8 - $55 | 116% |
| Fallon Health | $8 - $55 | 116% |
| Family Life Insurance Company | $8 - $55 | 116% |
| Ghc Scw | $8 - $55 | 116% |
| Group Pension Administrators | $8 - $55 | 116% |
| International Benefit Administrators | $8 - $55 | 116% |
| Lifetime Benefit Solutions | $8 - $55 | 116% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $8 | 116% |
| Manhattan Life | $8 - $55 | 116% |
| Medi Share | $8 - $55 | 116% |
| Multiplan | $8 - $55 | 116% |
| Mvp | $8 - $55 | 116% |
| Pai | $8 - $55 | 116% |
| Pan-American Life | $8 - $55 | 116% |
| Paramount Hmo | $8 - $55 | 116% |
| Phcs | $8 - $55 | 116% |
| Trinity Health Share | $8 - $55 | 116% |
| U Of M Health Plan | $8 - $57 | 116% |
| Acclaim | $9 - $57 | 131% |
| Administrative Concepts | $9 - $57 | 131% |
| Allegeant | $9 - $57 | 131% |
| Ameriben | $9 - $57 | 131% |
| American Family | $9 - $57 | 131% |
| American Healthcare Alliance | $9 - $57 | 131% |
| American Republic | $9 - $57 | 131% |
| Amerihealth | $9 - $57 | 131% |
| Aultcare | $9 - $57 | 131% |
| Automated Benefit Services | $9 - $57 | 131% |
| Auxiant | $9 - $57 | 131% |
| Bcn Domestic | $9 | 131% |
| Benefit Administrative Systems,Llc | $9 - $57 | 131% |
| Blue Benefit Administrators Of Massachusetts | $9 | 131% |
| Blue Care Network | $9 | 131% |
| Blue Distinction Transplant | $9 | 131% |
| Blue Shield - Ca | $9 | 131% |
| Blue Shield - Id (Regence) | $9 | 131% |
| Blue Shield - Ny Highmark Northeastern | $9 | 131% |
| Blue Shield - Ny Highmark Western | $9 | 131% |
| Blue Shield - Pa (Highmark) | $9 | 131% |
| Blue Shield - Wa (Regence) | $9 | 131% |
| Boon Chapman | $9 - $57 | 131% |
| Cam Administrative Services | $9 - $57 | 131% |
| Christian Brother Services | $9 - $57 | 131% |
| Christian Brothers Holy Cross | $9 - $57 | 131% |
| Comprehensive Benefits | $9 - $57 | 131% |
| Continental Life Insurance | $9 - $57 | 131% |
| Coventry | $9 - $59 | 131% |
| Custom Benefit Administrators | $9 - $57 | 131% |
| Employee Benefit Concepts | $9 - $57 | 131% |
| Employee Benefit Management | $9 - $57 | 131% |
| Enterprise Group Planning | $9 - $57 | 131% |
| First Health | $9 - $59 | 131% |
| Freedom Life Insurance Company | $9 - $57 | 131% |
| Geha | $9 - $57 | 131% |
| Group Administrators | $9 - $57 | 131% |
| Group Marketing Services | $9 - $57 | 131% |
| Guardian | $9 - $57 | 131% |
| Health America | $9 - $57 | 131% |
| Health Choices | $9 - $57 | 131% |
| Healthez | $9 - $57 | 131% |
| Humana | $9 - $75 | 131% |
| Insight | $9 - $57 | 131% |
| Intercare | $9 - $57 | 131% |
| Jfp Benefit Management | $9 - $57 | 131% |
| Jp Farley Corporation | $9 - $57 | 131% |
| Kaiser Domestic | $9 | 131% |
| Key Benefit Administrator | $9 - $57 | 131% |
| Liberty Union Life Assurance Co | $9 - $57 | 131% |
| Lucent Health | $9 - $57 | 131% |
| Luminare Health | $9 - $57 | 131% |
| Luminare Health (Detroit) | $9 - $57 | 131% |
| Medben | $9 - $57 | 131% |
| Medcost | $9 - $57 | 131% |
| Molina Marketplace | $9 | 131% |
| Mutual Health Services | $9 - $57 | 131% |
| Mutual Of Omaha | $9 - $57 | 131% |
| Ncas | $9 - $57 | 131% |
| Nippon Life Ins | $9 - $57 | 131% |
| Nova | $9 - $57 | 131% |
| Painters Union Insurance Fund | $9 - $57 | 131% |
| Physicians Mutual | $9 - $57 | 131% |
| Plumbers Local 98 Insurance Fund | $9 - $57 | 131% |
| Prairie States | $9 - $57 | 131% |
| Primary Physician Care | $9 - $57 | 131% |
| Professional Benefit Administrators | $9 - $57 | 131% |
| The Loomis Company | $9 - $57 | 131% |
| Unicare | $9 - $57 | 131% |
| Us Health And Life | $9 - $57 | 131% |
| Valenz | $9 - $57 | 131% |
| Western & Southern Financial Group | $9 - $57 | 131% |
| Wps | $9 - $57 | 131% |
| Medical Mutual | $10 | 145% |
| Meritain | $10 | 145% |
| Preferred One | $10 | 145% |
| Cmh Allegan County | $11 - $75 | 160% |
| Cmh Ausable Valley | $11 - $75 | 160% |
| Cmh Barry County | $11 - $75 | 160% |
| Cmh Berrien County | $11 - $75 | 160% |
| Cmh Cass County | $11 - $75 | 160% |
| Cmh Clinton-Eaton-Ingham County | $11 - $75 | 160% |
| Cmh Kalamazoo | $11 - $75 | 160% |
| Cmh Kent County | $11 - $75 | 160% |
| Cmh Lenawee County | $11 - $75 | 160% |
| Cmh Misc | $11 - $75 | 160% |
| Cmh Monroe County | $11 - $75 | 160% |
| Cmh Montcalm County | $11 - $75 | 160% |
| Cmh Muskegon County | $11 - $75 | 160% |
| Cmh Newaygo County | $11 - $75 | 160% |
| Cmh North Country | $11 - $75 | 160% |
| Cmh Northern Lakes County | $11 - $75 | 160% |
| Cmh Ottawa County | $11 - $75 | 160% |
| Cmh Van Buren County | $11 - $75 | 160% |
| Cmh West Mi County | $11 - $75 | 160% |
| Magellan Behavioral Health | $11 - $75 | 160% |
| Vitalcore | $11 | 160% |
| Wellpath | $11 | 160% |
| Priority Health | $42 - $43 | 610% |