CMS Price Transparency Data

Blood test, lipase

Facility: Lancaster General Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $16
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Lancaster General Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.32x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $49 (711%)
Insurance Median: $16 (232%)
Cash: $49 (711% of Medicare)
Ins. Median: $16 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Amerihealth Caritas $5 - $7 73%
Lancaster County Mh $5 73%
Medicaid / KanCare $5 - $13 73%
Gateway $6 87%
Tricare $6 87%
UnitedHealthcare $6 - $42 87%
Aetna $7 - $30 102%
Albright Life $7 102%
Blue Cross Blue Shield $7 - $42 102%
Cigna $7 - $41 102%
Coatesville Va $7 102%
Devoted Health $7 102%
Health Partners Mcr Advantage $7 102%
Highmark $7 - $49 102%
Hospice Generic $7 102%
Lebanon Veterans Hospital $7 102%
Medicare (plans) $7 - $8 102%
Pa Health And Wellness Mcr $7 102%
Upmc For You $8 116%
Hospice And Community Care $9 131%
Elap Employees $10 145%
Old Order Group $13 - $16 189%
Oscar Health Plan $13 189%
Lg Coresource/Lg Eliance $14 203%
Highmark Commercial Preferred $15 - $49 218%
Lancashire Hall $15 - $49 218%
Nursing Home Op Services $15 218%
Affilia Home Health $20 - $49 290%
Claim Watcher Plus $21 305%
Masonic Homes $21 - $49 305%
Eliance Health Solutions $22 - $31 319%
Claim Watcher $23 334%
Highmark Commercial Non-Preferred $23 - $49 334%
Elap Other Groups $25 363%
Preferred Healthcare $29 - $42 421%
Ehp $40 581%
Upmc Commercial $40 - $42 581%
Devon $42 610%
Geisinger Commercial $42 610%
Intergroup Services $42 610%
Medi-Share Christian Care $47 682%
Commercial Generic $49 711%
Magellan $49 711%
United Behavioral Health $49 711%
Value Options $49 711%
Workers Compensation $49 711%
Gift Of Life Donor Program $13,500 195936%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals