CMS Price Transparency Data

Blood test, lipase

Facility: Mercy St Francis Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $147
Cash Discount Price: $106
vs. Medicare Baseline: 21.34x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Mercy St Francis Hospital is $147. 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 21.34x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $147 (2134%)

Cash: $106 (1538% of Medicare)

Ins. Median: $147 (2134% 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 2134% of the Medicare baseline (a markup of 2034%). 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	$7 - $158	102%
Cherokee Nation Health Serv Contracted [320066]	$7	102%
Cigna	$7 - $155	102%
Cross Timbers Hospice [20098]	$7	102%
Dept Of Veteran Affairs Contracted [320106]	$7	102%
Elara Caring Aspire Hospice [20433]	$7	102%
Halo Hcr Inc Hospice Contracted [320432]	$7	102%
Halo Hcr Inc Hospice [20432]	$7	102%
Humana	$7 - $147	102%
Indian Health Service Contracted [320198]	$7	102%
Kindful Hospice Contracted [320434]	$7	102%
Kindful Hospice [20434]	$7	102%
Medicaid / KanCare	$7 - $85	102%
Medical Associates Health Contracted [320444]	$7	102%
Medicare (plans)	$7 - $58	102%
Mercy Hospice Okc [20252]	$7	102%
Mercy Mgd Behavioral Health Contracted [320259]	$7	102%
Pace Of The Ozarks Contracted [320518]	$7	102%
Provider Partners Health Plans Contracted [320450]	$7	102%
Qual Choice Contracted [320325]	$7	102%
UnitedHealthcare	$7 - $155	102%
Centivo Contracted [320505]	$11	160%
Tricare	$55	798%
Aetna	$56 - $145	813%
Globalhealth Contracted [320145]	$56	813%
Administrative Payor Contracted [320005]	$73	1060%
Healthscope Contracted [320182]	$74	1074%
Ambetter / Centene	$85	1234%
Home State Health Plan Contracted [320187]	$85	1234%
Novasys Contracted [320285]	$85	1234%
Healthlink Contracted [320179]	$106 - $155	1538%
Preferred Health Plan Contracted [320522]	$106	1538%
Workers Comp [20426]	$130 - $139	1887%
Auxiant Contracted [320462]	$147 - $155	2134%
Mercy Benefit Admin Contracted [320251]	$147 - $155	2134%
Point C Contracted [320238]	$147 - $155	2134%
United Medical Resources Contracted [320454]	$147 - $152	2134%
Medica Contracted [320239]	$154	2235%
90 Degree Benefits Contracted [320436]	$155	2250%
Aither Health Contracted [320449]	$155	2250%
Benefit Management Contracted [320052]	$155	2250%
Ebms Contracted [320493]	$155	2250%
Edison Health Solutions Contracted [320502]	$155	2250%
Evolutions Health Care Contracted [320124]	$155	2250%
First Health Contracted [320128]	$155	2250%
Health Systems Inc Contracted [320174]	$155	2250%
Imagine 360 Contracted [320494]	$155	2250%
Insurance System Inc Contracted [320465]	$155	2250%
Multiplan Contracted [320270]	$155	2250%
Point C [20238]	$155	2250%
Private Health Care Systems Contracted [320320]	$155	2250%
Reflect Health Contracted [320492]	$155	2250%
Show-Me Health Administrators Contracted [320483]	$155	2250%
Usa Managed Care Org Contracted [320429]	$155	2250%
Yuzu Health Contracted [320521]	$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 St Francis 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.