CMS Price Transparency Data

Blood test, lipase

Facility: Memorial Hospital for Cancer and Allied Diseases

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $37
Cash Discount Price: $199
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Memorial Hospital for Cancer and Allied Diseases is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.37x the Medicare baseline. Located in 1275 York Ave, New York, NY.

Cash / Self-Pay

$199

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: $199 (2888%)

Insurance Median: $37 (537%)

Cash: $199 (2888% 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.

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
Emblem	$9 - $112	131%
Healthfirst	$18 - $119	261%
Fidelis	$20 - $24	290%
Cigna	$24	348%
Oxford	$28	406%
UnitedHealthcare	$28	406%
Aetna	$35 - $74	508%
Empire	$47 - $59	682%
Magnacare	$127 - $159	1843%
Metroplus	$129	1872%
Urn	$141	2046%
6 Degrees Health	$155	2250%
Multiplan	$179	2598%

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 $199.
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 Memorial Hospital for Cancer and Allied Diseases 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.