CMS Price Transparency Data

Blood test, lipase

Facility: Southern Coos Hospital & Health Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $77
Cash Discount Price: $101
vs. Medicare Baseline: 11.18x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Southern Coos Hospital & Health Center is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 11.18x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $101 (1466%)

Insurance Median: $77 (1118%)

Cash: $101 (1466% of Medicare)

Ins. Median: $77 (1118% 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 1118% of the Medicare baseline (a markup of 1018%). 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
Healthnet - All Plans	$5 - $9	73%
Tricare	$41 - $75	595%
Advanced Health - All Plans	$45 - $81	653%
Aetna	$47 - $116	682%
Atrio Mcr Adv - Allplans	$47 - $85	682%
Confederated Tribes - All Plans	$47 - $85	682%
Moda Mcr Adv	$47 - $85	682%
Pacific Source Mcr Adv	$47 - $85	682%
Cigna	$56 - $102	813%
Moda Health Plan - All Other Plans	$63 - $114	914%
Prov Netwrk Of America - All Plans	$64 - $116	929%
Three Rivers - All Plans	$64 - $116	929%
UnitedHealthcare	$64 - $116	929%
Blue Cross Blue Shield	$66 - $120	958%
First Choice - All Plans	$66 - $118	958%
Multiplan - All Plans	$66 - $120	958%
First Health - All Plans	$68 - $122	987%
Pacific Source - All Other Plans	$68 - $122	987%
Providence Preferred - All Plans	$68 - $122	987%

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 $101.
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 Southern Coos Hospital & Health 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.