CMS Price Transparency Data

Blood test, lipase

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $106
Cash Discount Price: $8
vs. Medicare Baseline: 15.38x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Hackensack Meridian Mountainside Medical is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.38x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $8 (116%)

Insurance Median: $106 (1538%)

Cash: $8 (116% of Medicare)

Ins. Median: $106 (1538% 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 1538% of the Medicare baseline (a markup of 1438%). 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
Healthscope Benefits [2290]	$13 - $106	189%
UnitedHealthcare	$13	189%
Aetna	$19	276%
Black Lung [6055]	$51	740%
Create Flex / Select [3580]	$51	740%
Healthcare Highways [2210]	$51 - $106	740%
Lucent Health [6000]	$51	740%
Medicare (plans)	$51	740%
Oncology Patient Assistance Programs [2295]	$51	740%
Selecthealth [3740]	$51	740%
Web Tpa [2115]	$51	740%
Worker'S Comp [2125]	$51 - $116	740%
Wtc Healthcare Sme Karna [8005]	$51	740%
First Health [1375]	$94 - $106	1364%
Cigna	$100	1451%
Administrative Concepts [1005]	$106	1538%
Allied National Global Care [1035]	$106	1538%
Gilsbar [1425]	$106	1538%
Healthcost Solutions [2415]	$106	1538%
Healthfirst [2395]	$106	1538%
Healthnet [1495]	$106	1538%
Hometown Health [2155]	$106	1538%
Mayo Clinic Health Solutions [2280]	$106	1538%
Multiplan [1680]	$106	1538%
Mutual Of Omaha [1685]	$106	1538%
New Era Life Insurance Company [1705]	$106	1538%
Pan American Life Insurance Co [1770]	$106	1538%
Pba [1775]	$106	1538%
Phcs [1780]	$106	1538%
Planned Administrators Inc [2360]	$106	1538%
Resource One Administrators [2815]	$106	1538%
Trustmark [2030]	$106	1538%
Universal Fidelity [2085]	$106	1538%
Emblem Health [2430]	$116	1684%
Humana	$116	1684%
Blue Cross Blue Shield	$123	1785%
Amerihealth [3520]	$125	1814%
Mva [1690]	$125	1814%

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 $8.
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 Hackensack Meridian Mountainside Medical 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.