CMS Price Transparency Data

Blood test, lipase

Facility: Licking Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $104
  • Cash Discount Price: $173
  • vs. Medicare Baseline: 15.09x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Licking Memorial Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.09x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$173

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: $173 (2511%)
Insurance Median: $104 (1509%)
Cash: $173 (2511% 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.

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
Aetna $7 - $168 102%
Blue Cross Blue Shield $7 - $198 102%
Champva [500001] $7 102%
Cigna $7 - $208 102%
Humana $7 - $224 102%
Medicare (plans) $7 102%
Tricare $7 102%
UnitedHealthcare $7 - $196 102%
Veterans Administration [100068] $7 102%
Wellcare By Allwell [450104] $7 102%
Molina Marketplace [100106] $11 160%
Medical Mutual [100114] $64 - $191 929%
Medben [700068] $81 - $226 1176%
Allied Benefit Systems [100015] $83 - $166 1205%
Geha [100039] $83 - $166 1205%
Gravie Administrative Services [100165] $83 - $166 1205%
Meritain [100063] $83 - $166 1205%
Optima [700069] $83 - $166 1205%
Trustmark Small Business Benefits [100263] $83 - $166 1205%
Webtpa [100127] $83 - $166 1205%
Benicomp [70090] $87 - $173 1263%
Consociate Health 6 Degrees [100059] $92 - $185 1335%
Consociate Health [100029] $92 - $185 1335%
Healthscope [100157] $98 - $196 1422%
Surest [100016] $98 - $196 1422%
United Medical Resources [700071] $98 - $196 1422%
American Postal Workers [100089] $104 - $208 1509%
Antidote Health Plan Of Ohio [70006803] $104 - $208 1509%
Coresource [100002] $104 - $231 1509%
Great West Life [700064] $104 - $208 1509%
National Association Of Letter Carriers [100067] $104 - $208 1509%
Ohio Healthy Luminare Health [100264] $104 - $208 1509%
Ohio Healthy [100255] $104 - $208 1509%
Ohio Ppo Connect [70006801] $104 - $208 1509%
Osu Prime Care [100254] $104 - $208 1509%
Quality Care Partners [70006802] $104 - $208 1509%
The Health Plan [100261] $104 - $208 1509%
Wellfleet Group, Llc [100164] $104 - $208 1509%
Coventry [100010] $107 - $213 1553%
Pan American Life [700070] $107 - $213 1553%
Ohio Health Choice [100109] $111 - $221 1611%
Administrative Concepts [100006] $112 - $224 1626%
Carefactor [100087] $112 - $224 1626%
Philadelphia American Life [100260] $112 - $231 1626%
Reliance Standard-Asrm [100258] $112 - $224 1626%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals