CMS Price Transparency Data

Blood test, lipase

Facility: Cannon Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $110
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 15.97x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Cannon Memorial Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.97x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $78 (1132%)
Insurance Median: $110 (1597%)
Cash: $78 (1132% of Medicare)
Ins. Median: $110 (1597% 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 1597% of the Medicare baseline (a markup of 1497%). 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
Aetna $5 73%
Mail Handlers Benefit Plan [327] $5 73%
Rural Carrier Benefit Plan [406] $5 73%
Blue Cross Blue Shield $8 - $147 116%
Planned Administrators [886] $8 - $110 116%
Absolute Total Care [58] $9 131%
Humana $9 - $112 131%
Medicaid / KanCare $9 - $155 131%
Other Hospital Payers [1991] $9 - $155 131%
Select Health Of Sc [637] $9 131%
Employee Benefit Management Services [869] $43 624%
Blue Choice Health Plan [922] $62 - $118 900%
Geha [302] $83 1205%
Golden Rule Ins Co [584] $83 1205%
UnitedHealthcare $83 - $155 1205%
Phcs [940] $84 - $102 1219%
Cigna $92 - $155 1335%
Nalc Health Benefit Plan [291] $92 1335%
Medcost [206] $93 - $140 1350%
Preferred Administrators [19] $93 1350%
Coventry Health [245] $97 - $112 1408%
Thomas Cooper & Company [315] $110 1597%
American Continental Ins [778] $155 2250%
American Republic Life Ins [722] $155 2250%
Business Office [6000] $155 2250%
Covid19 Hrsa Uninsured Testing And Treatment Fund [17] $155 2250%
First Health [946] $155 2250%
Guarantee Trust Life Insurance [236] $155 2250%
Home Health Infusion Payer [6001] $155 2250%
Manhattan Life Ins Co [932] $155 2250%
Medicare (plans) $155 2250%
Miscellaneous Commercial [1] $155 2250%
New Era Life Ins Co [437] $155 2250%
Non-Contracted [22] $155 2250%
Physicians Mutual [773] $155 2250%
Reference Based Pricing/Limited Plan [21] $155 2250%
State Farm Ins Co [373] $155 2250%
Sterling Investors Life [244] $155 2250%
Supermed/Med Mutual Of Ohio [539] $155 2250%
United American Ins Co [277] $155 2250%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 W G Acker Drive, Pickens, SC 29671
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals