CMS Price Transparency Data

Blood test, lipase

Facility: Clarion Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $13
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Clarion Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.89x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $38 (552%)
Insurance Median: $13 (189%)
Cash: $38 (552% of Medicare)
Ins. Median: $13 (189% 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.

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
Medicaid / KanCare $5 73%
Amerihealth $6 - $7 87%
Martin'S Point - Usfhp $6 - $23 87%
Tricare $6 87%
Upmc $6 - $35 87%
Aetna $7 - $60 102%
Cigna $7 - $34 102%
Devoted Health Plan $7 - $27 102%
Gateway $7 - $25 102%
Geisinger $7 - $8 102%
Highmark $7 - $23 102%
Highmark Community Blue $7 102%
Medicare (plans) $7 102%
Pa Health & Wellness $7 102%
The Health Plan $7 - $16 102%
UnitedHealthcare $7 102%
American Health Plan $8 116%
Jefferson Health Plan $8 116%
Highmark - Ind.& Managed Care $15 - $23 218%
Peak Health $16 - $47 232%
Devon $50 726%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals