CMS Price Transparency Data

Blood test, lipase

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $85
Cash Discount Price: $71
vs. Medicare Baseline: 12.34x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Cincinnati Children's Hospital Medical Center is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 12.34x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $71 (1030%)

Insurance Median: $85 (1234%)

Cash: $71 (1030% of Medicare)

Ins. Median: $85 (1234% 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 1234% of the Medicare baseline (a markup of 1134%). 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
Aetna	$7 - $133	102%
Humana	$7 - $18	102%
Passport_Ky	$7	102%
United_Health_Care_Ky	$7	102%
Wellcare_Ky	$7	102%
Blue Cross Blue Shield	$9 - $138	131%
Caresource_In	$9	131%
Mhs_In	$9	131%
Caresource_Oh	$18	261%
United_Health_Care_Oh	$18	261%
Amerihealth_Caritas_Oh	$19	276%
Molina_Oh	$19	276%
Buckeye_Oh	$20	290%
Caresource_Oh_Insurance	$42 - $67	610%
Cigna	$42 - $133	610%
Medical_Mutual_Of_Ohio_Insurance	$54 - $133	784%
Point_Comfort_Insurance	$57 - $91	827%
Margaret_Mary_Health_Insurance	$68 - $109	987%
Parkview_Signature_Care_Insurance	$68 - $109	987%
United_Health_Care_Insurance	$78 - $125	1132%
Health_Ohio_Network_Insurance	$79 - $133	1147%
Custom_Design_Benefits_Insurance	$83 - $133	1205%
Health_Smart_Preferred_Insurance	$83 - $133	1205%
Medical_Benefit_Administrators_Insurance	$83 - $133	1205%
Ohio_Health_Choice_Insurance	$83 - $133	1205%
Private_Health_Care_Systems_Insurance	$84 - $134	1219%
Beechstreet_Insurance	$85 - $137	1234%
First_Health_Group_Insurance	$85 - $137	1234%
Health_Link_Insurance	$85 - $137	1234%
Evolutions_Health_Care_Systems	$87 - $140	1263%
Galaxy_Health_Insurance	$87 - $140	1263%

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 $71.
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 Cincinnati Children's Hospital 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.