CMS Price Transparency Data

Blood test, lipase

Facility: North Carolina Baptist Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $40
Cash Discount Price: $60
vs. Medicare Baseline: 5.81x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at North Carolina Baptist Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.81x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$60

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $60 (871%)

Insurance Median: $40 (581%)

Cash: $60 (871% of Medicare)

Ins. Median: $40 (581% 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 581% of the Medicare baseline (a markup of 481%). 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 - $105	102%
Apex	$7	102%
Blue Cross Blue Shield	$7 - $45	102%
Cigna	$7 - $74	102%
Devoted	$7	102%
Healthteam	$7	102%
Humana	$7 - $67	102%
Medicare (plans)	$7	102%
UnitedHealthcare	$7 - $42	102%
Wellcare	$7 - $13	102%
Liberty	$8	116%
Medcost	$12 - $82	174%
Alliance	$13	189%
Amerihealth	$13 - $29	189%
Carolina Complete	$13	189%
Health Blue	$13	189%
Partners	$13	189%
Trillium	$13	189%
Vaya	$13	189%
Ambetter / Centene	$26 - $28	377%
Oscar	$35 - $44	508%
Directnet	$69 - $73	1001%
Cone Health	$81 - $86	1176%
Healthgram	$81 - $86	1176%
First Carolina Care	$93 - $98	1350%
Private Healthcare Systems	$95 - $101	1379%
Multiplan	$104 - $111	1509%

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 $60.
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 North Carolina Baptist 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.