CMS Price Transparency Data

Blood test, lipase

Facility: Atrium Health Pineville

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $109
Cash Discount Price: $141
vs. Medicare Baseline: 15.82x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Atrium Health Pineville is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.82x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.

Cash / Self-Pay

$141

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $141 (2046%)

Insurance Median: $109 (1582%)

Cash: $141 (2046% of Medicare)

Ins. Median: $109 (1582% 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 1582% of the Medicare baseline (a markup of 1482%). 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 - $233	102%
Cigna	$7 - $190	102%
Humana	$7	102%
UnitedHealthcare	$7 - $132	102%
Trillium	$8 - $30	116%
Alliance	$9 - $30	131%
Amerihealth Caritas	$9 - $29	131%
Blue Cross Blue Shield	$9 - $109	131%
Carolina Complete Health	$9 - $29	131%
Healthy Blue	$9 - $29	131%
Ortho Carolina	$9	131%
Partners	$9 - $28	131%
Vaya	$9 - $29	131%
Wellcare	$9 - $29	131%
Medcost	$15 - $168	218%
Ambetter / Centene	$82 - $102	1190%
Employers Health Network	$124 - $149	1800%
Physician Reach Out	$141	2046%
Magellan	$169	2453%
Gmmi	$183	2656%
Quik Trip	$183	2656%
Choicecare	$202 - $208	2932%
Healthgram	$225	3266%
Provider Select	$228 - $253	3309%
Private Health Care Systems	$231	3353%
First Health	$233	3382%
Beechstreet	$253	3672%
Multiplan	$259	3759%

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 $141.
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 Atrium Health Pineville 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.