CMS Price Transparency Data

Blood test, lipase

Facility: Essentia Health

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $37
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Essentia Health is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.37x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

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: $62 (900%)
Insurance Median: $37 (537%)
Cash: $62 (900% of Medicare)
Ins. Median: $37 (537% 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 537% of the Medicare baseline (a markup of 437%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Advocare/Security Health $7 102%
Blue Cross Blue Shield $7 - $55 102%
Freedom Blue Ppo $7 102%
Healthpartners Care Msho / Mcr Adv $7 102%
Imcare Msho Pcc Prime $7 102%
Imcare Msho Ref Req $7 102%
Itasca Med Care $7 102%
Medica Advantage Solutions $7 102%
Medica Msho/Dual Solutions $7 102%
Medica Prime Solution Group $7 102%
Medicare (plans) $7 102%
Nd Va Administration $7 102%
Platinum Blue/Vantage Blue $7 102%
Primewest $7 102%
Primewest Msho $7 102%
Secure Blue Msho $7 102%
Ubh Cost Plan $7 102%
Ubh Msho $7 102%
Ucare Msho $7 102%
UnitedHealthcare $7 - $65 102%
Medica Access $22 319%
Sanford Health Plan $22 - $37 319%
Healthpartners Care Pmap $32 464%
Ucare $34 - $54 493%
Wea $37 - $63 537%
America'S Ppo $40 - $64 581%
Wps $43 - $69 624%
Aetna $44 - $70 639%
Medica $45 - $51 653%
Medica Uplan $45 653%
Medica Choice $52 755%
Cigna $55 798%
Healthpartners $55 798%
Healthpartners Pcc Prime $55 798%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals