CMS Price Transparency Data

Blood test, lipase

Facility: Essentia Health St Mary's Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $61
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 8.85x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Essentia Health St Mary's Medical Center is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.85x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$61

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: $72 (1045%)
Insurance Median: $61 (885%)
Cash: $72 (1045% of Medicare)
Ins. Median: $61 (885% 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 885% of the Medicare baseline (a markup of 785%). 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
Advocare/Security Health $7 102%
Blue Cross Blue Shield $7 - $84 102%
Freedom Blue Ppo $7 102%
Healthpartners Care Msho / Mcr Adv $7 102%
Imcare Msho (Ref Req) $7 102%
Imcare Msho Pcc Prime $7 102%
Imcare Msho Ref Req $7 102%
Itasca Med Care $7 102%
Medica Advantage Solutions $7 102%
Medica Msho/Dual Solutions $7 102%
Medica Prime Solution Group $7 102%
Medicare (plans) $7 102%
Nd Va Administration $7 102%
Platinum Blue / Vantage Blue $7 102%
Primewest $7 102%
Primewest Msho $7 102%
Secure Blue Msho $7 102%
Ubh Cost Plan $7 102%
Ubh Msho $7 102%
Ucare Msho $7 102%
UnitedHealthcare $7 - $81 102%
Sanford Health Plan $22 - $50 319%
Medica Access $35 - $37 508%
Healthpartners Care Pmap $43 - $44 624%
Blue Plus Pmap Pcc Prime $47 - $56 682%
Medica $59 - $63 856%
Medica Uplan $59 - $61 856%
Healthpartners $64 - $79 929%
Medica Choice $65 - $68 943%
Ucare $70 - $73 1016%
Cigna $76 - $79 1103%
Healthpartners Pcc Prime $76 - $79 1103%
Wea $77 - $85 1118%
Security Health $82 - $85 1190%
America'S Ppo $83 - $86 1205%
Wps $89 - $93 1292%
Aetna $91 - $94 1321%
Healthscope Benefits $91 - $94 1321%
Healtheos $92 - $95 1335%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals