CMS Price Transparency Data

Blood test, lipase

Facility: Children's Nebraska

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $59
Cash Discount Price: Unavailable
vs. Medicare Baseline: 8.56x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Children's Nebraska is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.56x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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%)

Insurance Median: $59 (856%)

Ins. Median: $59 (856% 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 856% of the Medicare baseline (a markup of 756%). 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
Ambetter / Centene	$7	102%
Medicaid / KanCare	$7 - $55	102%
Molina (Iowa)	$7	102%
Wellpoint	$7	102%
Molina (Nebraska)	$10	145%
Midlands Choice Chi	$47 - $125	682%
Blue Cross Blue Shield	$48 - $143	697%
UnitedHealthcare	$51 - $150	740%
Midlands Choice Elevate	$54 - $143	784%
Avera Health Plan	$57 - $152	827%
Centivo	$57 - $152	827%
Wellmark	$57 - $152	827%
Aetna	$59 - $158	856%
Midlands Choice	$59 - $158	856%
Sanford Health Plan	$59 - $158	856%

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 $X.
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 Children's Nebraska 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.