CMS Price Transparency Data

Blood test, lipase

Facility: Gettysburg Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $24
Cash Discount Price: $28
vs. Medicare Baseline: 3.48x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Gettysburg Hospital is $24. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.48x the Medicare baseline. Located in 147 Gettys Street, Gettysburg, PA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$24

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: $28 (406%)

Insurance Median: $24 (348%)

Cash: $28 (406% of Medicare)

Ins. Median: $24 (348% 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 348% of the Medicare baseline (a markup of 248%). 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
Medicaid / KanCare	$5 - $12	73%
Aetna	$7 - $32	102%
Johns_Hopkins_Healthcare_Plan	$7 - $33	102%
Medicare (plans)	$7 - $8	102%
Upmc_For_Life_Community_Healthchoices	$8	116%
Highmark	$10 - $40	145%
Blue_Cross	$17 - $30	247%
United_Healthcare	$21	305%
First_Health_Network	$28 - $32	406%
Phc	$28	406%
Upmc	$28 - $33	406%
Cigna	$29 - $31	421%
Wellspan_Capital_Blue_Cross	$32	464%
Geisinger	$33	479%

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 $28.
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 Gettysburg Hospital 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.