CMS Price Transparency Data

Blood test, lipase

Facility: Roxborough Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $7
  • Cash Discount Price: $6
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Roxborough Memorial Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 1.02x the Medicare baseline. Located in 5800 Ridge Ave, Philadelphia, PA.
Cash / Self-Pay
$6

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $6 (87%)
Insurance Median: $7 (102%)
Cash: $6 (87% of Medicare)
Ins. Median: $7 (102% 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
Health Partners Plan $5 - $10 73%
Keystone $5 - $7 73%
Humana $6 87%
Medicaid / KanCare $6 87%
UnitedHealthcare $6 - $8 87%
Blue Cross Blue Shield $7 - $34 102%
Cigna $7 102%
Medicare (plans) $7 102%
Pa Health & Wellness $7 - $8 102%
Providers Partner Health Plan $7 102%
Spartan $7 102%
Tricare $7 102%
Auto Insurance $8 116%
Worker Compensation $8 116%
Employer Direct Healthcare $10 145%
Naphcare $11 160%
Highmark $14 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5800 Ridge Ave, Philadelphia, PA 19128
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals