CMS Price Transparency Data

Blood test, lipase

Facility: Fairfield Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $22
Cash Discount Price: $19
vs. Medicare Baseline: 3.19x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Fairfield Medical Center is $22. 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 3.19x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$19

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: $19 (276%)

Insurance Median: $22 (319%)

Cash: $19 (276% 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.

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
Humana	$6 - $50	87%
Aetna	$7 - $35	102%
Allied Benefit Systems	$7 - $37	102%
Blue Cross Blue Shield	$7 - $26,250	102%
Buckeye Community Health	$7 - $11	102%
Caresource	$7 - $11	102%
Medical Mutual	$7 - $33,500	102%
Medicare (plans)	$7	102%
Medigold	$7	102%
Meritain Health	$7 - $37	102%
Molina	$7 - $11	102%
Oscar	$7	102%
The Health Plan	$7 - $37	102%
UnitedHealthcare	$7 - $16	102%
Va Ccn	$7	102%
Valor Health Plan	$7	102%
Bwc	$10	145%
Amerihealth Caritas Ohio	$11	160%
Medicaid / KanCare	$11	160%
Quality Care Partners/Ohio Ppo Connect	$22 - $38	319%
The Ohio State Health Plan	$24 - $41	348%
Cigna	$26 - $44	377%
Multiplan	$29 - $50	421%
Ohio Healthy	$29 - $50	421%
Miscellaneous Plans	$31 - $53	450%

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 $19.
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 Fairfield Medical Center 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.