CMS Price Transparency Data

Blood test, lipase

Facility: Mercy Hospital - Cassville

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $130
Cash Discount Price: $106
vs. Medicare Baseline: 18.87x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Hospital - Cassville is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 18.87x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $106 (1538%)

Insurance Median: $130 (1887%)

Cash: $106 (1538% of Medicare)

Ins. Median: $130 (1887% 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 1887% of the Medicare baseline (a markup of 1787%). 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
Aetna	$6 - $145	87%
Humana	$6 - $139	87%
Medicaid / KanCare	$6 - $85	87%
Blue Cross Blue Shield	$7 - $158	102%
Medicare (plans)	$7 - $70	102%
UnitedHealthcare	$10 - $155	145%
Dept Of Veteran Affairs Contracted [320106]	$56	813%
Tricare	$66	958%
Cherokee Nation Health Serv Contracted [320066]	$67	972%
Cigna	$67 - $155	972%
Cross Timbers Hospice [20098]	$67	972%
Elara Caring Aspire Hospice [20433]	$67	972%
Globalhealth Contracted [320145]	$67	972%
Halo Hcr Inc Hospice Contracted [320432]	$67	972%
Halo Hcr Inc Hospice [20432]	$67	972%
Indian Health Service Contracted [320198]	$67	972%
Kindful Hospice Contracted [320434]	$67	972%
Kindful Hospice [20434]	$67	972%
Medical Associates Health Contracted [320444]	$67	972%
Mercy Hospice Okc [20252]	$67	972%
Mercy Mgd Behavioral Health Contracted [320259]	$67	972%
Pace Of The Ozarks Contracted [320518]	$67	972%
Provider Partners Health Plans Contracted [320450]	$67	972%
Qual Choice Contracted [320325]	$67	972%
Healthscope Contracted [320182]	$68	987%
Administrative Payor Contracted [320005]	$73	1060%
Centivo Contracted [320505]	$83	1205%
Ambetter / Centene	$85	1234%
Home State Health Plan Contracted [320187]	$85	1234%
Novasys Contracted [320285]	$85	1234%
Healthlink Contracted [320179]	$106 - $147	1538%
Preferred Health Plan Contracted [320522]	$106	1538%
Health Systems Inc Contracted [320174]	$130	1887%
Insurance System Inc Contracted [320465]	$130	1887%
Point C Contracted [320238]	$130 - $147	1887%
Point C [20238]	$130	1887%
United Medical Resources Contracted [320454]	$130 - $139	1887%
Workers Comp [20426]	$130 - $147	1887%
Municipal Health Plan Contracted [320271]	$132	1916%
Medica Contracted [320239]	$146	2119%
90 Degree Benefits Contracted [320436]	$147	2134%
Aither Health Contracted [320449]	$147	2134%
American Healthcare Alliance Contracted [320020]	$147	2134%
Auxiant Contracted [320462]	$147	2134%
Benefit Management Contracted [320052]	$147	2134%
Ebms Contracted [320493]	$147	2134%
Edison Health Solutions Contracted [320502]	$147	2134%
Evolutions Health Care Contracted [320124]	$147	2134%
Imagine 360 Contracted [320494]	$147	2134%
Mercy Benefit Admin Contracted [320251]	$147	2134%
Reflect Health Contracted [320492]	$147	2134%
Show-Me Health Administrators Contracted [320483]	$147	2134%
Usa Managed Care Org Contracted [320429]	$147	2134%
Yuzu Health Contracted [320521]	$147	2134%
First Health Contracted [320128]	$155	2250%
Multiplan Contracted [320270]	$155	2250%
Private Health Care Systems Contracted [320320]	$155	2250%

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 $106.
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 Mercy Hospital - Cassville 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.