CMS Price Transparency Data

Blood test, lipase

Facility: St Louis Childrens Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $35
Cash Discount Price: $28
vs. Medicare Baseline: 5.08x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at St Louis Childrens Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.08x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $28 (406%)

Insurance Median: $35 (508%)

Cash: $28 (406% of Medicare)

Ins. Median: $35 (508% 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 508% of the Medicare baseline (a markup of 408%). 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	$7 - $37	102%
Blue Cross Blue Shield	$7 - $40	102%
Cox Health [757]	$7	102%
Essence Healthcare [221]	$7	102%
Humana	$7 - $35	102%
Medica [662]	$7	102%
UnitedHealthcare	$7 - $35	102%
Cigna	$23 - $26	334%
Healthlink [225]	$23 - $35	334%
Consociate [478]	$25	363%
Sarah Bush Lincoln [636]	$25	363%
Apwu Health Plan [216]	$26	377%
Nalc Health Benefit Plan [242]	$26	377%
Priority Health [648]	$26	377%
Allied Benefits [498]	$27 - $37	392%
Hope Trust [806]	$27	392%
Cox Health Systems Insurance Company [220]	$31 - $35	450%
Med-Pay [480]	$31 - $35	450%
Unicare [568]	$31 - $35	450%
Health Alliance [224]	$33	479%
Healthscope Benefits [258]	$34 - $38	493%
Beechstreet [551]	$35	508%
Detego Health [868]	$35	508%
First Health Commercial [734]	$35	508%
Health Systems Inc [620]	$35	508%
Healthcare Sol Mercy [609]	$35	508%
Multiplan Commercial [737]	$35	508%
Multiplan [240]	$35	508%
Phcs [244]	$35 - $38	508%
Preferred Health Professionals [561]	$35	508%
Coresource [497]	$37	537%
Fmh Benefit Service Inc [222]	$37	537%
Mail Handlers [495]	$37	537%
Medica [661]	$38	552%
Hfn [563]	$40	581%

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 $28.
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 St Louis Childrens 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.