CMS Price Transparency Data

Blood test, lipase

Facility: Sanford Wheaton Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $80
Cash Discount Price: $74
vs. Medicare Baseline: 11.61x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Sanford Wheaton Medical Center is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 11.61x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.

Cash / Self-Pay

$74

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $74 (1074%)

Insurance Median: $80 (1161%)

Cash: $74 (1074% of Medicare)

Ins. Median: $80 (1161% 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 1161% of the Medicare baseline (a markup of 1061%). 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	$22 - $85	319%
Sanford Health Plan Align	$46	668%
Aetna	$50 - $80	726%
Health Partners	$50 - $75	726%
Medicare (plans)	$50	726%
Ucare	$50 - $81	726%
UnitedHealthcare	$50 - $77	726%
Primewest	$51 - $56	740%
Security Health Plan	$51	740%
Sanford Health Plan	$73 - $85	1060%
Medica	$81 - $87	1176%
First Choice Health Network	$83	1205%
Healthez	$83	1205%
Multiplan	$83	1205%

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 $74.
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 Sanford Wheaton Medical Center 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.