CMS Price Transparency Data

Blood test, lipase

Facility: Pennsylvania Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $115
  • Cash Discount Price: $334
  • vs. Medicare Baseline: 16.69x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Pennsylvania Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $334. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 16.69x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$334

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $334 (4848%)
Insurance Median: $115 (1669%)
Cash: $334 (4848% of Medicare)
Ins. Median: $115 (1669% 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 1669% of the Medicare baseline (a markup of 1569%). 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
Cigna $4 - $113 58%
Gateway Health Plan $5 - $9 73%
Medicaid / KanCare $5 - $334 73%
Pa Medical Assistance $5 73%
Keystone Mercy Health Plan $6 87%
Aetna $7 - $334 102%
Blue Cross Blue Shield $7 - $334 102%
Clover Health Plan $7 102%
Geisinger Health Plan $7 - $22 102%
Health Partners $7 - $334 102%
Humana $7 - $267 102%
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%
UnitedHealthcare $7 - $334 102%
Upmc $7 - $334 102%
Keystone First $8 116%
Tricare $8 116%
Us Family Health Plan $8 116%
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%
Horizon Nj Health $56 - $59 813%
Pgm - Regie De L'Assurance Maladie Quebec $77 1118%
Preferred Health Care Eliance $87 1263%
Pgm - Kuwait Defense $117 - $150 1698%
Devon $127 - $150 1843%
Qualcare $127 1843%
Coventry $134 - $170 1945%
Pgm - Chop $134 1945%
Wissahickon Hospice $134 1945%
Healthamerica/Coventry $150 - $164 2177%
Olympus $162 2351%
First Health Global $167 2424%
Urn-Cancer Resource Services $167 2424%
Health Net $200 2903%
Pgm - Royal Embassy Of Saudi Arabia $200 2903%
Pgm - Embassy Of Qatar $217 3149%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $217 3149%
Pgm - Embassy Of The United Emirates/Ipc $234 3396%
Devon Health Services Inc $267 3875%
Health America/Ccn $267 3875%
Intergroup $267 3875%
Pgm - Kuwait Health Division $267 3875%
Pgm - Kuwait Oil $267 3875%
Preferred Care $267 3875%
Commercial Other $334 4848%
Community Behavioral Health $334 4848%
International Pfs $334 4848%
Quest Behavioral Health $334 4848%
United Behavioral Health $334 4848%
Workers Compensation $334 4848%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals