CMS Price Transparency Data

Blood test, lipase

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $75
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 10.89x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Nationwide Children's Hospital Toledo, LLC is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.89x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $120 (1742%)
Insurance Median: $75 (1089%)
Cash: $120 (1742% of Medicare)
Ins. Median: $75 (1089% 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 1089% of the Medicare baseline (a markup of 989%). 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
Caresource $7 102%
Mcclaren Health Plan - Michigan $7 102%
Molina $7 - $13 102%
Cigna $11 160%
Amerihealth $13 189%
Bchp $13 189%
Blue Cross Blue Shield $13 - $109 189%
Humana $13 189%
UnitedHealthcare $13 - $108 189%
Front Path Health Coalition $21 - $96 305%
Mmo $46 - $75 668%
Aetna $71 - $82 1030%
Mcclaren Health Plan $83 - $96 1205%
Ohc $92 - $107 1335%
Ohio Ppo Connect $92 - $107 1335%
First Health $142 - $165 2061%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2213 Cherry Street, Toledo, OH 43608
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens