CMS Price Transparency Data

Blood test, lipase

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $33
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 4.79x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Mercy Hospital Tishomingo Inc is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 4.79x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$43

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: $43 (624%)
Insurance Median: $33 (479%)
Cash: $43 (624% 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.

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 - $44 87%
Humana $6 - $53 87%
Medicaid / KanCare $6 - $20 87%
Health Choice Contracted [320166] $9 131%
Blue Cross Blue Shield $18 - $32 261%
Ambetter / Centene $20 290%
Home State Health Plan Contracted [320187] $20 290%
Novasys Contracted [320285] $20 290%
Webtpa Contracted [320417] $28 406%
Medicare (plans) $30 - $42 435%
Cherokee Nation Health Serv Contracted [320066] $32 464%
Cross Timbers Hospice [20098] $32 464%
Dept Of Veteran Affairs Contracted [320106] $32 464%
Elara Caring Aspire Hospice Contracted [320433] $32 464%
Elara Caring Aspire Hospice [20433] $32 464%
Globalhealth Contracted [320145] $32 464%
Halo Hcr Inc Hospice Contracted [320432] $32 464%
Halo Hcr Inc Hospice [20432] $32 464%
Independent Health [20197] $32 464%
Indian Health Service Contracted [320198] $32 464%
Kindful Hospice Contracted [320434] $32 464%
Kindful Hospice [20434] $32 464%
Medical Associates Health [20444] $32 464%
Mercy Hospice Okc [20252] $32 464%
Provider Partners Health Plans Contracted [320450] $32 464%
Qual Choice Contracted [320325] $32 464%
Tribute Health Plan Mcr Contracted [320338] $32 464%
Tricare $32 464%
UnitedHealthcare $32 - $52 464%
Cigna $33 - $50 479%
Aither Health Contracted [320449] $40 - $56 581%
Mercy Benefit Admin Contracted [320251] $40 - $56 581%
Quik Trip Contracted [320447] $40 581%
Show-Me Health Administrators Contracted [320483] $40 581%
Medica Contracted [320239] $42 610%
First Health Contracted [320128] $44 639%
Osma Health Contracted [320292] $46 668%
Benefit Management Contracted [320052] $50 - $59 726%
Healthcare Highways Plus Contracted [320175] $50 726%
Private Health Care Systems Contracted [320320] $50 - $53 726%
United Medical Resources Contracted [320454] $52 755%
Multiplan Contracted [320270] $53 - $59 769%
Auxiant Contracted [320462] $56 813%
Ebms Contracted [320493] $56 813%
Healthlink Contracted [320179] $56 813%
Imagine 360 Contracted [320494] $56 813%
Preferred Community Choice Contracted [320311] $56 813%
Reflect Health Contracted [320492] $56 813%
Yuzu Health Contracted [320521] $56 813%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals