CMS Price Transparency Data

Blood test, lipase

Facility: UPMC Wellsboro

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $141
Cash Discount Price: $154
vs. Medicare Baseline: 20.46x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at UPMC Wellsboro is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 20.46x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.

Cash / Self-Pay

$154

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $154 (2235%)

Insurance Median: $141 (2046%)

Cash: $154 (2235% of Medicare)

Ins. Median: $141 (2046% 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 2046% of the Medicare baseline (a markup of 1946%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$5	73%
Geisinger	$6 - $156	87%
Highmark Wholecare (Prev Gateway)	$6 - $47	87%
UnitedHealthcare	$6 - $198	87%
Upmc Health Plan	$6 - $102	87%
Upmc Work Partners	$7	102%
Health Partners Plans (Jefferson Health Plan)	$8	116%
Pa Health & Wellness	$9 - $50	131%
Aetna	$38 - $201	552%
Blue Cross Blue Shield	$42 - $118	610%
Cigna	$44 - $49	639%
Wirerope Works	$117 - $130	1698%
Multiplan	$165 - $221	2395%
America'S Choice	$190 - $210	2758%
Intergroup	$190 - $210	2758%

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 $154.
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 UPMC Wellsboro 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.