CMS Price Transparency Data

Blood test, lipase

Facility: Bayshore Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $53
Cash Discount Price: $7
vs. Medicare Baseline: 7.69x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Bayshore Medical Center is $53. 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 7.69x the Medicare baseline. Located in 727 N Beers St, Holmdel, NJ.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $53 (769%)

Cash: $7 (102% of Medicare)

Ins. Median: $53 (769% 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 769% of the Medicare baseline (a markup of 669%). 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
United Community/Americhoice	$7	102%
Vaccn	$7	102%
Wellcare	$7	102%
Clover	$7	102%
Amerigroup	$7	102%
Aetna	$7 - $103	102%
Seoul Medical Group	$7	102%
UnitedHealthcare	$8 - $15	116%
Oxford	$14	203%
Qualcare	$31 - $116	450%
Cigna	$32 - $106	464%
Horizon	$38 - $114	552%
Bergen Risk	$47 - $99	682%
Brighton Health Plan	$50 - $106	726%
Multiplan - PHCS	$54 - $112	784%
Amerihealth	$54 - $128	784%

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 $7.
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 Bayshore Medical Center 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.