CMS Price Transparency Data

Blood test, lipase

Facility: Wilkes Regional Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $65
Cash Discount Price: $64
vs. Medicare Baseline: 9.43x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Wilkes Regional Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.43x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $64 (929%)

Insurance Median: $65 (943%)

Cash: $64 (929% of Medicare)

Ins. Median: $65 (943% 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 943% of the Medicare baseline (a markup of 843%). 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
Healthteam	$7	102%
Alliance	$13	189%
Amerihealth	$13 - $74	189%
Carolina Complete	$13	189%
Healthblue	$13	189%
Partners	$13	189%
Trillium	$13	189%
UnitedHealthcare	$13 - $68	189%
Vaya	$13	189%
Wellcare	$13	189%
Medcost	$37 - $91	537%
Aetna	$49 - $88	711%
Blue Cross Blue Shield	$49 - $75	711%
Ambetter / Centene	$60 - $78	871%
Cigna	$67 - $69	972%
Oscar	$70 - $83	1016%
Directnet	$76	1103%
Private Healthcare Systems	$115	1669%
Multiplan	$118	1713%

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 $64.
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 Wilkes Regional Medical Center 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.