CMS Price Transparency Data

Blood test, lipase

Facility: Ira Davenport Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $104
Cash Discount Price: $101
vs. Medicare Baseline: 15.09x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Ira Davenport Memorial Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.09x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $101 (1466%)

Insurance Median: $104 (1509%)

Cash: $101 (1466% of Medicare)

Ins. Median: $104 (1509% 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 1509% of the Medicare baseline (a markup of 1409%). 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
Empire	$3	44%
Amerihealth Caritas Mcr Adv - All Plans	$7	102%
Blue Cross Blue Shield	$7 - $507	102%
Fidelis	$7	102%
Humana	$7 - $150	102%
Tricare	$7	102%
UnitedHealthcare	$14 - $175	203%
Fidelis Care - Exchange - All Plans	$92	1335%
Geisinger - All Plans	$97	1408%
Cigna	$104	1509%
Mvp Health Plan - All Plans	$104	1509%
Independent Health - All Plans	$109	1582%
Upmc - All Plans	$115	1669%
Pomco Inc - All Plans	$120	1742%
Aetna	$125 - $149	1814%
Emblem Health - All Plans	$147	2134%
Emblem/Ghi	$154	2235%
Martins Point - All Plans	$167	2424%
Healthnow - All Plans	$550	7983%

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 $101.
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 Ira Davenport Memorial Hospital 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.