CMS Price Transparency Data

Blood test, lipase

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $116
Cash Discount Price: $148
vs. Medicare Baseline: 16.84x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at UPMC Children's Hospital of Pittsburgh is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 16.84x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$148

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $148 (2148%)

Insurance Median: $116 (1684%)

Cash: $148 (2148% of Medicare)

Ins. Median: $116 (1684% 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 1684% of the Medicare baseline (a markup of 1584%). 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
Aetna	$6 - $135	87%
Amerihealth Caritas	$7 - $19	102%
Blue Cross Blue Shield	$7 - $57	102%
Cigna	$7 - $135	102%
Health Plan Of Upper Ohio Valley	$7 - $160	102%
Upmc Health Plan	$12 - $55	174%
Health Partners Plans (Jefferson Health Plan)	$19	276%
Highmark Wholecare (Prev Gateway)	$20	290%
Pa Health & Wellness	$20	290%
UnitedHealthcare	$20 - $116	290%
Geisinger	$21 - $111	305%
Intergroup	$160 - $209	2322%
Coventry/First Health	$197	2859%
Saudi Armed Forces	$197	2859%
Health Payors Organization	$209	3033%
Multiplan	$209	3033%
National Provider Network	$221	3208%
Private Health Care Systems	$221	3208%

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 $148.
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 Children's Hospital of Pittsburgh 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.