CMS Price Transparency Data

Blood test, lipase

Facility: Charlevoix Area Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $24
Cash Discount Price: $40
vs. Medicare Baseline: 3.48x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Charlevoix Area Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.48x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $40 (581%)

Insurance Median: $24 (348%)

Cash: $40 (581% of Medicare)

Ins. Median: $24 (348% 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 348% of the Medicare baseline (a markup of 248%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$5 - $64	73%
Mclaren Health Plan	$5 - $64	73%
Meridian	$5	73%
Priority Health	$5 - $69	73%
UnitedHealthcare	$5 - $60	73%
Cigna	$7 - $69	102%
Hap (Health Alliance Plan)	$10 - $55	145%
Provider Network Of America/Hma Group Health	$10 - $59	145%
Aetna	$12 - $62	174%
Blue Care Network	$12 - $32	174%
Medicare (plans)	$12 - $32	174%
Michigan Amish Medical Board	$12 - $32	174%
Northern Michigan Mennonite Group	$12 - $32	174%
Molina	$13 - $35	189%
Hospice Of Michigan	$15 - $41	218%
Asr Physicians Care Network	$20 - $55	290%
Employee Benefits Logistics	$20 - $55	290%
Enterprise Group Planning Employee Benefit Plan	$20 - $55	290%
First Health/Coventry Health/Community Care Network	$20 - $55	290%
Medical Cost Savings Solution	$20 - $55	290%
Three Rivers Provider Network	$22 - $59	319%
Iba Health And Life Assurance Company	$23 - $63	334%
Cofinity	$24 - $64	348%
Nomi Health	$24 - $64	348%
Preferred Medical Claim Solutions	$24 - $66	348%

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 $40.
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 Charlevoix Area 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.