CMS Price Transparency Data

Blood test, lipase

Facility: Wooster Community Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $15
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 2.18x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Wooster Community Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.18x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $19 (276%)
Insurance Median: $15 (218%)
Cash: $19 (276% of Medicare)
Ins. Median: $15 (218% 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 218% of the Medicare baseline (a markup of 118%). 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
Blue Cross Blue Shield $5 - $11 73%
Buckeye Mcare $7 102%
Caresource Mcr Adv $7 102%
Humana $7 - $18 102%
Med Mutual Of Oh Mcr $7 102%
Molina Mcr $7 102%
Summacare Mcr $7 102%
The Health Plan Mcr Adv $7 102%
Tricare $7 102%
UnitedHealthcare $7 - $18 102%
Valor Hp Mcr-All Plans $7 102%
Aultcare/Primecare Mcr Adv $9 131%
Magnipower-All Plans $9 131%
Buckeye Mcaid-All Other Plans $10 145%
Caresource Exch - All Other Plans $10 145%
Caresource Mcaid $10 145%
Molina Mcaid $10 145%
Aetna $11 - $19 160%
Amerihealth Mcaid-All Plans $11 160%
Molina Marketplace - All Other Plans $12 174%
Clarity Health - All Plans $13 189%
Aultcare Wayne County $14 203%
Aultcare/Primetime Exch $14 203%
Cerco-All Plans $14 203%
Rayco-All Plans $14 203%
Christian Health Ministries-All Plans $15 218%
Cigna $15 218%
Health Ohio Network Employer $15 218%
Wayne County-All Plans $15 218%
Health Ohio Network Ppo-All Other Plans $16 232%
Healthsmart Accel $16 232%
Healthsmart Complete Ppo-All Other Plans $16 232%
Ohio Health Choice Supp $16 232%
Ohio Health Group Hlthy - All Other Plans $16 232%
Summacare Preferred Choice $16 232%
Aultcare/Primetime-All Other Plans $17 247%
Health Plan Of Upper Ohio-All Plans $17 247%
Med Mutual Of Oh Exchange $17 247%
Med Mutual Of Oh Supermed $17 247%
Med Mutual Of Oh Trad-All Other Plans $17 247%
Ohio Health Group Pref $17 247%
The Health Plan Comm - All Other Plans $17 247%
Healthsmart Hpo $18 261%
Healthsmart Ppo $18 261%
Ohio Health Choice-All Other Plans $18 261%
Osu-All Plans $18 261%
Summacare-All Other Plans $18 261%
Beech Street-All Plans $19 276%
Central Benefits-All Plans $19 276%
First Health-All Plans $19 276%
Flora-All Plans $19 276%
Phcs-All Plans $19 276%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals