CMS Price Transparency Data

Blood test, lipase

Facility: Raritan Bay Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $52
  • Cash Discount Price: $7
  • vs. Medicare Baseline: 7.55x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Raritan Bay Medical Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 7.55x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$7

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $7 (102%)
Insurance Median: $52 (755%)
Cash: $7 (102% of Medicare)
Ins. Median: $52 (755% 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 755% of the Medicare baseline (a markup of 655%). 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
United Community/Americhoice $7 102%
Clover $7 102%
Amerigroup $7 102%
Seoul Medical Group $7 102%
Wellcare $7 102%
Vaccn $7 102%
Aetna $8 - $103 116%
UnitedHealthcare $8 - $15 116%
Karna $9 131%
Oxford $14 203%
Cigna $32 - $106 464%
Qualcare $42 - $120 610%
Bergen Risk $47 - $99 682%
Activecare First McO $47 - $99 682%
Horizon $48 - $128 697%
Brighton Health Plan $50 - $106 726%
Multiplan - PHCS $54 - $112 784%
Amerihealth $55 - $128 798%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals