CMS Price Transparency Data
Blood test, lipase
Facility: Mercy Hospital Springfield
Billing Code: 83690 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83690
- Insurance Median: $55
- Cash Discount Price: $110
- vs. Medicare Baseline: 7.98x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Hospital Springfield is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 7.98x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$110
Average discount available for prompt cash payment at this facility.
Insurance Median
$55
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: $110 (1597%)
Insurance Median: $55 (798%)
Cash: $110 (1597% of Medicare)
Ins. Median: $55 (798% 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 798% of the Medicare baseline (a markup of 698%). 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 | $5 - $131 | 73% |
| Aetna | $6 - $8 | 87% |
| Humana | $6 - $117 | 87% |
| Medicaid / KanCare | $6 - $13 | 87% |
| Centurion Of Missouri [20459] | $7 | 102% |
| Champva [20065] | $7 | 102% |
| Cherokee Nation Health Serv Contracted [320066] | $7 | 102% |
| Cigna | $7 - $39 | 102% |
| Cross Timbers Hospice [20098] | $7 | 102% |
| Dept Of Veteran Affairs Contracted [320106] | $7 | 102% |
| Elara Caring Aspire Hospice [20433] | $7 | 102% |
| Globalhealth Contracted [320145] | $7 | 102% |
| Halo Hcr Inc Hospice Contracted [320432] | $7 | 102% |
| Halo Hcr Inc Hospice [20432] | $7 | 102% |
| Indian Health Service Contracted [320198] | $7 | 102% |
| Indian Health Service [20198] | $7 | 102% |
| Kindful Hospice Contracted [320434] | $7 | 102% |
| Kindful Hospice [20434] | $7 | 102% |
| Medica Contracted [320239] | $7 | 102% |
| Medica [20239] | $7 | 102% |
| Medicare (plans) | $7 | 102% |
| Mercy Hospice Okc [20252] | $7 | 102% |
| Mercy Mgd Behavioral Health Contracted [320259] | $7 | 102% |
| Mercy Rehab Hospital Contracted [320260] | $7 | 102% |
| Pace Of The Ozarks Contracted [320518] | $7 | 102% |
| Provider Partners Health Plans Contracted [320450] | $7 | 102% |
| Qual Choice Contracted [320325] | $7 | 102% |
| Tricare | $7 | 102% |
| United Medical Resources Contracted [320454] | $7 - $89 | 102% |
| UnitedHealthcare | $7 - $132 | 102% |
| Healthscope Contracted [320182] | $8 | 116% |
| Centivo Contracted [320505] | $11 | 160% |
| Ambetter / Centene | $13 | 189% |
| Home State Health Plan Contracted [320187] | $13 | 189% |
| Novasys Contracted [320285] | $13 | 189% |
| Providrs Care Network Contracted [320484] | $13 | 189% |
| Aither Health Contracted [320449] | $14 - $98 | 203% |
| Auxiant Contracted [320462] | $14 - $112 | 203% |
| Ebms Contracted [320493] | $14 | 203% |
| Healthlink Contracted [320179] | $14 - $41 | 203% |
| Imagine 360 Contracted [320494] | $14 | 203% |
| Mercy Benefit Admin Contracted [320251] | $14 - $98 | 203% |
| Reflect Health Contracted [320492] | $14 | 203% |
| Yuzu Health Contracted [320521] | $14 | 203% |
| 90 Degree Benefits Contracted [320436] | $40 | 581% |
| Show-Me Health Administrators Contracted [320483] | $40 - $42 | 581% |
| Benefit Management Contracted [320052] | $67 - $69 | 972% |
| Health Systems Inc Contracted [320174] | $67 - $69 | 972% |
| Insurance System Inc Contracted [320465] | $67 - $69 | 972% |
| Administrative Payor Contracted [320005] | $75 - $86 | 1089% |
| Evolutions Health Care Contracted [320124] | $75 - $77 | 1089% |
| Point C Contracted [320238] | $75 - $129 | 1089% |
| Point C [20238] | $75 - $77 | 1089% |
| Medical Destinations Contracted [320242] | $84 - $86 | 1219% |
| Workers Comp [20426] | $84 - $146 | 1219% |
| First Health Contracted [320128] | $94 - $96 | 1364% |
| Edison Health Solutions Contracted [320502] | $95 - $98 | 1379% |
| Federal Medical Center Contracted [320127] | $100 - $103 | 1451% |
| Multiplan Contracted [320270] | $129 - $132 | 1872% |
| Private Health Care Systems Contracted [320320] | $129 - $132 | 1872% |
| Compcare Of The Ozarks Contracted [320437] | $132 - $136 | 1916% |
| American Healthcare Alliance Contracted [320020] | $134 - $138 | 1945% |
| Qual Choice Contracted [320324] | $134 - $138 | 1945% |
| Municipal Health Plan Contracted [320271] | $135 - $139 | 1959% |
| Usa Managed Care Org Contracted [320429] | $147 - $151 | 2134% |
| Ppo Plus Contracted [320310] | $150 - $155 | 2177% |