CMS Price Transparency Data

Blood test, lipase

Facility: Samaritan Hospital of Troy, New York

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $22
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Samaritan Hospital of Troy, New York is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.19x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $59 (856%)
Insurance Median: $22 (319%)
Cash: $59 (856% of Medicare)
Ins. Median: $22 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Albany County Correctional Facility $6 87%
Blue Cross Blue Shield $6 - $32 87%
Medicaid / KanCare $6 - $91 87%
Nascentia Health Options $6 87%
Aetna $7 - $22 102%
Eddy Seniorcare Pace $7 102%
Hudson Headwaters Pace $7 102%
Medicare (plans) $7 - $91 102%
Mvp $7 102%
Secure Horizons Ma Pffs $7 102%
UnitedHealthcare $7 - $91 102%
Nascentia Health Plus $8 116%
Fidelis Care $12 174%
Wellpath $16 232%
Harvard Pilgrim Healthcare $17 247%
Bcn Domestic $18 261%
Blue Care Network $18 261%
Unicare $18 261%
Blue Shield - Ny Highmark Northeastern $19 - $32 276%
1199 National Benefit Fund $22 319%
Allied Benefit Systems $22 319%
Asr Health Benefits $22 319%
Christian Brother Services $22 319%
Geha $22 319%
Lucent Health $22 319%
Luminare Health $22 319%
Medical Mutual $22 319%
Meritain $22 319%
Trustmark Small Business Benefits $22 319%
Blue Shield - Ca $32 464%
Blue Shield - Id (Regence) $32 464%
Blue Shield - Ny Highmark Western $32 464%
Blue Shield - Pa (Highmark) $32 464%
Blue Shield - Wa (Regence) $32 464%
Allegiance $41 595%
American Postal Workers Secondary $41 595%
Cigna $41 595%
Diversified Administrators $41 595%
Health Partners $41 595%
Priority Health $41 595%
Tufts Health Plan $41 595%
Webtpa $41 595%
Emblem Health $46 668%
Nova $46 668%
First Health $73 1060%
Health Republic $77 1118%
Independent Health $77 1118%
Magnacare $77 1118%
Health New England $82 1190%
Multiplan $82 1190%
Phcs $82 1190%
Carelon Behavioral Health $91 1321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals