CMS Price Transparency Data

Blood test, lipase

Facility: Mercy Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $16
  • Cash Discount Price: $29
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.32x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
$29

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $29 (421%)
Insurance Median: $16 (232%)
Cash: $29 (421% of Medicare)
Ins. Median: $16 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
The Health Plan $6 - $36 87%
Aetna $7 - $45 102%
Cigna $7 - $8 102%
Communicare $7 102%
Humana $7 102%
Mmo $7 - $15 102%
Perennial Health $7 102%
Summacare $7 - $15 102%
United $7 - $10 102%
Amerihealth $10 145%
Blue Cross Blue Shield $10 - $29 145%
Buckeye $10 145%
Caresource $10 145%
Molina $10 145%
Oscar $14 - $17 203%
Zing Health $14 203%
Aultcare $18 261%
Cc Ehp $18 - $19 261%
Amish Community Aid Plan $20 - $22 290%
Immergrun $22 319%
Ohcp $22 319%
Omas $22 319%
Ohio Healthy $24 348%
Php $27 392%
Phphi $27 392%
Gms $32 464%
Medical Benefit Corp $32 464%
Consociate Health $34 493%
Frontpath $40 581%
Managed Care Services $40 581%
Multiplan $40 581%
Tertiary Care Network $40 581%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals