CMS Price Transparency Data

Blood test, lipase

Facility: Helen Newberry Joy Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $26
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 3.77x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Helen Newberry Joy Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.77x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $36 (522%)
Insurance Median: $26 (377%)
Cash: $36 (522% of Medicare)
Ins. Median: $26 (377% 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 377% of the Medicare baseline (a markup of 277%). 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
Mi Wc - All Plans $2 - $70 29%
Aetna $5 - $104 73%
Blue Cross Blue Shield $5 - $109 73%
Uphg Tpa - All Plans $5 - $99 73%
Cigna $6 - $107 87%
First Health - All Plans $6 - $104 87%
Health Alliance - All Plans $6 - $107 87%
Healtheos - All Plans $6 - $107 87%
Ppom/Cofinity - All Plans $6 - $104 87%
Priority Health - All Plans $6 - $107 87%
UnitedHealthcare $6 - $107 87%
Uphp Mcaid - All Plans $6 - $52 87%
Vital Core - All Plans $6 - $107 87%
Va - All Plans $7 - $45 102%
Humana $8 - $44 116%
Mi Health Link - All Plans $8 - $44 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Harrie St, Newberry, MI 49868
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals