CMS Price Transparency Data
Blood test, lipase
Facility: Mount Carmel New Albany Surgical Hospital
Billing Code: 83690 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 83690
- Insurance Median: $33
- Cash Discount Price: $46
- vs. Medicare Baseline: 4.79x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mount Carmel New Albany Surgical Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 4.79x the Medicare baseline. Located in 7333 Smith's Mill Road, New Albany, OH.
Cash / Self-Pay
$46
Average discount available for prompt cash payment at this facility.
Insurance Median
$33
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: $46 (668%)
Insurance Median: $33 (479%)
Cash: $46 (668% of Medicare)
Ins. Median: $33 (479% 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 479% of the Medicare baseline (a markup of 379%). 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.
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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 | $6 - $71 | 87% |
| Medicare (plans) | $6 - $7 | 87% |
| Rural Carrier Health Benefit Plan | $6 | 87% |
| Blue Benefit Administrators Of Massachusetts | $7 | 102% |
| Blue Care Network | $7 | 102% |
| Blue Cross Blue Shield | $7 - $71 | 102% |
| Blue Distinction Transplant | $7 | 102% |
| Blue Shield - Ca | $7 | 102% |
| Blue Shield - Id (Regence) | $7 | 102% |
| Blue Shield - Ny Highmark Northeastern | $7 | 102% |
| Blue Shield - Ny Highmark Western | $7 | 102% |
| Blue Shield - Pa (Highmark) | $7 | 102% |
| Blue Shield - Wa (Regence) | $7 | 102% |
| Hospice Mount Carmel | $7 | 102% |
| Oscar | $7 | 102% |
| The Health Plan | $7 - $47 | 102% |
| UnitedHealthcare | $7 - $69 | 102% |
| Enterprise Group Planning | $13 | 189% |
| Medical Mutual | $13 - $56 | 189% |
| Custom Design Benefits | $14 | 203% |
| Quality Care Partners | $16 | 232% |
| Western & Southern Financial Group | $18 | 261% |
| American Postal Workers Secondary | $29 | 421% |
| Cigna | $29 | 421% |
| Health Partners | $29 | 421% |
| Healthgram | $29 | 421% |
| Mvp | $29 | 421% |
| Priority Health | $29 | 421% |
| Geha | $32 - $69 | 464% |
| Gravie Admin Services | $32 | 464% |
| Healthez | $32 | 464% |
| Meritain | $32 | 464% |
| Webtpa | $32 | 464% |
| Access Health | $33 | 479% |
| Acclaim | $33 | 479% |
| Administrative Concepts | $33 | 479% |
| Allegeant | $33 | 479% |
| Allied Benefit Systems | $33 | 479% |
| American Family | $33 | 479% |
| American Healthcare Alliance | $33 | 479% |
| American National | $33 | 479% |
| American Republic | $33 | 479% |
| Amerihealth | $33 | 479% |
| Aultcare | $33 | 479% |
| Automated Benefit Services | $33 | 479% |
| Auxiant | $33 | 479% |
| Benefit Administrative Systems,Llc | $33 | 479% |
| Boon Chapman | $33 | 479% |
| Cam Administrative Services | $33 | 479% |
| Christian Brother Services | $33 | 479% |
| Christian Brothers Holy Cross | $33 | 479% |
| Claimchoice Adminstrators | $33 | 479% |
| Comprehensive Benefits | $33 | 479% |
| Continental Life Insurance | $33 | 479% |
| Coventry | $33 | 479% |
| Custom Benefit Administrators | $33 | 479% |
| Cypress Benefit Administrators | $33 | 479% |
| Employee Benefit Concepts | $33 | 479% |
| Employee Benefit Management | $33 | 479% |
| Forest County Potawatomi | $33 | 479% |
| Freedom Life Insurance Company | $33 | 479% |
| Group Administrators | $33 | 479% |
| Group Marketing Services | $33 | 479% |
| Group Pension Administrators | $33 | 479% |
| Guardian | $33 | 479% |
| Health America | $33 | 479% |
| Health Choices | $33 | 479% |
| Healthcare Management Admin | $33 | 479% |
| Insight | $33 | 479% |
| Intercare | $33 | 479% |
| Jfp Benefit Management | $33 | 479% |
| Jp Farley Corporation | $33 | 479% |
| Key Benefit Administrator | $33 | 479% |
| Liberty Union Life Assurance Co | $33 | 479% |
| Lucent Health | $33 | 479% |
| Luminare Health | $33 | 479% |
| Magnacare | $33 | 479% |
| Medcost | $33 | 479% |
| Mutual Health Services | $33 | 479% |
| Mutual Of Omaha | $33 | 479% |
| Ncas | $33 | 479% |
| Nippon Life Ins | $33 | 479% |
| Nova | $33 | 479% |
| Painters Union Insurance Fund | $33 | 479% |
| Physicians Mutual | $33 | 479% |
| Plumbers Local 98 Insurance Fund | $33 | 479% |
| Prairie States | $33 | 479% |
| Preferred One | $33 | 479% |
| Primary Physician Care | $33 | 479% |
| Professional Benefit Administrators | $33 | 479% |
| Secureone Preferred United Plans | $33 | 479% |
| Siho Insurance Services | $33 | 479% |
| Sisco Benefits | $33 | 479% |
| The Loomis Company | $33 | 479% |
| Trustmark Small Business Benefits | $33 | 479% |
| U Of M Health Plan | $33 | 479% |
| Unicare | $33 | 479% |
| Unified Group Services | $33 | 479% |
| Us Health And Life | $33 | 479% |
| Valenz | $33 | 479% |
| Varipro | $33 | 479% |
| Wps | $33 | 479% |
| Humana | $36 - $71 | 522% |
| First Health | $37 | 537% |
| Consociate | $43 | 624% |
| Health Ohio Network | $43 | 624% |
| Medben | $43 - $53 | 624% |
| Caresource | $52 | 755% |
| Healthlink Inc | $53 | 769% |
| Medical Benefits Mutual | $53 | 769% |
| Ohio Health Choice | $53 | 769% |
| Ohio Ppo Connect | $53 | 769% |
| Ameriben | $57 | 827% |
| Luminare Health (Detroit) | $57 | 827% |
| Medi Share | $57 | 827% |
| Multiplan | $57 | 827% |
| Ohiohealthy | $57 | 827% |
| Osu Not Independent Choice | $57 | 827% |
| Phcs | $57 | 827% |
| Philadelphia American Life Insurance | $57 | 827% |
| Twin Valley Psychiatric | $57 | 827% |
| Health Smart | $60 | 871% |
| Bccp | $71 | 1030% |
| Medicaid / KanCare | $71 | 1030% |
| Optima Health | $71 | 1030% |
| Crime Victim Assistance | $632 | 9173% |
| Ohio Safe Program | $632 | 9173% |