CMS Price Transparency Data

Blood test, lipase

Facility: Penn State Health St. Joseph

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $8
Cash Discount Price: $12
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Penn State Health St. Joseph is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.16x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$12

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $12 (174%)

Insurance Median: $8 (116%)

Cash: $12 (174% of Medicare)

Ins. Median: $8 (116% 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.

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
[Amerihealth Caritas]	$6 - $7	87%
[Geisinger]	$6 - $32	87%
[Health Partners Plans]	$6 - $7	87%
[Highmark Wholecare]	$6 - $7	87%
[Pa Health & Wellness]	$6 - $7	87%
Aetna	$7 - $19	102%
Humana	$7	102%
UnitedHealthcare	$7 - $30	102%
[Cbc]	$7 - $24	102%
[Healthspring]	$7	102%
[Highmark]	$7 - $26	102%
[Ibc]	$7 - $22	102%
[Upmc]	$7 - $33	102%
[Point Comfort Underwriters]	$9	131%
Cigna	$20	290%
[Highmark Choice Blue]	$21	305%
[Highmark Aca]	$22	319%
[Preferred Healthcare Systems]	$34	493%
[First Health]	$36	522%
[Multiplan]	$36	522%

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 $12.
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 Penn State Health St. Joseph 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.