CMS Price Transparency Data

Blood test, lipase

Facility: Adena Pike Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $25
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 3.63x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Adena Pike Medical Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.63x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $16 (232%)
Insurance Median: $25 (363%)
Cash: $16 (232% of Medicare)
Ins. Median: $25 (363% 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 363% of the Medicare baseline (a markup of 263%). 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 $8 - $50 116%
Blue Cross Blue Shield $8 - $28 116%
Buckeye Community Health Plan $8 116%
Care Source $8 116%
Humana $8 - $31 116%
Medical Mutual Of Ohio $8 - $21 116%
Medigold $8 116%
Molina $8 116%
Gateway Health $11 160%
Molina Marketplace $13 189%
Care Source Just4Me $14 203%
Sidecar Health $22 319%
Ohio Ppo Connect $23 334%
The Health Plan $23 334%
Cigna $24 348%
Medical Mutual Of Ohio Supermed $25 363%
First Health $26 - $50 377%
Ohio Health Choice $26 377%
Healthsmart $31 450%
Integrated Health Plan $31 450%
Multiplan/Private Healthcare Systems $31 450%
Three Rivers Network $31 450%
UnitedHealthcare $80 1161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals