CMS Price Transparency Data

Blood test, lipase

Facility: Mercy Hospital Ada

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $16
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Hospital Ada is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.32x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $62 (900%)
Insurance Median: $16 (232%)
Cash: $62 (900% of Medicare)
Ins. Median: $16 (232% 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 232% of the Medicare baseline (a markup of 132%). 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 $6 - $123 87%
Humana $6 - $7 87%
Medicaid / KanCare $6 - $9 87%
Blue Cross Blue Shield $7 102%
Cherokee Nation Health Serv Contracted [320066] $7 102%
Cigna $7 102%
Cross Timbers Hospice [20098] $7 102%
Dept Of Veteran Affairs Contracted [320106] $7 102%
Elara Caring Aspire Hospice Contracted [320433] $7 102%
Elara Caring Aspire Hospice [20433] $7 102%
Globalhealth Contracted [320145] $7 102%
Halo Hcr Inc Hospice Contracted [320432] $7 102%
Halo Hcr Inc Hospice [20432] $7 102%
Independent Health [20197] $7 102%
Indian Health Service Contracted [320198] $7 102%
Kindful Hospice Contracted [320434] $7 102%
Kindful Hospice [20434] $7 102%
Medical Associates Health [20444] $7 102%
Medicare (plans) $7 - $164 102%
Mercy Hospice Okc [20252] $7 102%
Provider Partners Health Plans Contracted [320450] $7 102%
Qual Choice Contracted [320325] $7 102%
Tricare $7 102%
UnitedHealthcare $7 - $9 102%
Ambetter / Centene $9 131%
Health Choice Contracted [320166] $9 131%
Home State Health Plan Contracted [320187] $9 131%
Medica Contracted [320239] $9 - $164 131%
Novasys Contracted [320285] $9 131%
United Medical Resources Contracted [320454] $9 - $98 131%
Healthcare Highways Plus Contracted [320175] $10 - $123 145%
Webtpa Contracted [320417] $11 - $69 160%
Osma Health Contracted [320292] $12 - $74 174%
Benefit Management Contracted [320052] $13 - $107 189%
Healthsmart Preferred Care Contracted [320184] $15 218%
Kempton Contracted [320214] $15 218%
Aither Health Contracted [320449] $16 - $98 232%
Auxiant Contracted [320462] $16 - $98 232%
Ebms Contracted [320493] $16 - $98 232%
Federal Medical Center Contracted [320127] $16 - $98 232%
Globalhealth Contracted [320144] $16 - $103 232%
Healthlink Contracted [320179] $16 - $98 232%
Healthscope Contracted [320182] $16 - $98 232%
Imagine 360 Contracted [320494] $16 - $98 232%
Mercy Benefit Admin Contracted [320251] $16 - $107 232%
Point C Contracted [320238] $16 - $98 232%
Preferred Health Plan Contracted [320522] $16 - $98 232%
Quik Trip Contracted [320447] $16 - $98 232%
Reflect Health Contracted [320492] $16 - $98 232%
Show-Me Health Administrators Contracted [320483] $16 - $98 232%
Workers Comp [20426] $16 232%
Yuzu Health Contracted [320521] $16 - $98 232%
First Health Contracted [320128] $22 - $136 319%
Multiplan Contracted [320270] $22 - $139 319%
Private Health Care Systems Contracted [320320] $22 - $139 319%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals