CMS Price Transparency Data

Blood test, lipase

Facility: Hospital of Univ of Pennsylvania

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $64
  • Cash Discount Price: $289
  • vs. Medicare Baseline: 9.29x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Hospital of Univ of Pennsylvania is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.29x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$289

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $289 (4194%)
Insurance Median: $64 (929%)
Cash: $289 (4194% of Medicare)
Ins. Median: $64 (929% 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 929% of the Medicare baseline (a markup of 829%). 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
Gspp And Wissahickon Hospice $3 44%
Cigna $4 - $130 58%
Kaiser Permanente $5 - $289 73%
Medicaid / KanCare $5 - $289 73%
Pa Medical Assistance $5 - $289 73%
Keystone Mercy Health Plan $6 - $289 87%
UnitedHealthcare $6 - $289 87%
Aetna $7 - $289 102%
Blue Cross Blue Shield $7 - $185 102%
Clover Health Plan $7 102%
Devoted Health $7 102%
Geisinger Health Plan $7 - $22 102%
Health Partners $7 - $289 102%
Humana $7 - $231 102%
Ibc $7 102%
Medicare (plans) $7 102%
Pa Health And Wellness $7 - $11 102%
Penn Life (Living Independently For Elders) $7 102%
Philadelphia Va Medical Center $7 102%
Upmc $7 - $289 102%
Keystone First $8 116%
Tricare $8 116%
Us Family Health Plan $8 116%
Gateway Health Plan $9 131%
Elap $10 145%
Claims Watcher $11 - $12 160%
Centivo $12 174%
Ibc Commercial Hpn $12 174%
Oscar Health Plan $12 174%
Elap Services $13 189%
Keystone Hmo Proactive $13 189%
Highmark $14 203%
Penn Global Medicine $18 261%
Paired Kidney Exchange $23 334%
Horizon Nj Health $49 - $51 711%
Preferred Health Care Eliance $64 929%
Pgm - Regie De L'Assurance Maladie Quebec $66 958%
Pgm - Kuwait Defense $101 - $130 1466%
Qualcare $110 1597%
Olympus $114 1655%
Coventry $116 - $147 1684%
Pgm - Chop $116 1684%
Wissahickon Hospice $116 1684%
Healthamerica/Coventry $130 - $142 1887%
First Health Global $144 2090%
Health Net $173 2511%
Pgm - Royal Embassy Of Saudi Arabia $173 2511%
Pgm - Embassy Of Qatar $188 2729%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $188 2729%
Interlink $194 2816%
Pgm - Embassy Of The United Emirates/Ipc $202 2932%
Health America/Ccn $231 3353%
Intergroup $231 3353%
Pgm - Kuwait Health Division $231 3353%
Pgm - Kuwait Oil $231 3353%
Preferred Care $231 3353%
Blue Quality Centers For Transplant (Bqct) $289 4194%
City Of Philadelphia Behavioral Health $289 4194%
Commercial Other $289 4194%
International Pfs $289 4194%
United Behavioral Health $289 4194%
Workers Compensation $289 4194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals