CMS Price Transparency Data

Blood test, lipase

Facility: Tristar Southern Hills Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $17
  • Cash Discount Price: $236
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Tristar Southern Hills Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $236. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.47x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.
Cash / Self-Pay
$236

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $236 (3425%)
Insurance Median: $17 (247%)
Cash: $236 (3425% of Medicare)
Ins. Median: $17 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
Wellpoint $3 44%
Aetna $5 - $122 73%
Ambetter / Centene $7 102%
American Health Advantage $7 102%
Amerigroup $7 102%
Blue Cross Blue Shield $7 - $39 102%
Bright Health $7 - $8 102%
Devoted Health Plan $7 102%
Evergreen Hmo $7 102%
Healthspring $7 102%
Humana $7 - $61 102%
Odyssey Healthcare $7 102%
Sarah Cannon Research $7 102%
Signature Advantage $7 102%
United $7 - $110 102%
Wellcare $7 102%
Zing $7 102%
Atrio Golden Times $8 116%
Corvel Corporation $10 145%
Novanet $10 145%
Prime Health $10 - $215 145%
Cigna $12 - $80 174%
Oscar $21 305%
Kentucky Labor Cabinet $42 - $45 610%
Apex Health $43 - $46 624%
Nhc Advantage, Inc. $43 - $46 624%
Pruitt Health (Allyalign) $43 - $46 624%
Centurion $94 - $101 1364%
Bgfh Singlesource $114 - $207 1655%
Multiplan $132 - $142 1916%
Employers Health Network $160 - $171 2322%
Odom'S Tn Pride Sausage $171 - $183 2482%
Beech Street $201 - $215 2917%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 391 Wallace Rd, Nashville, TN 37211
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals