CMS Price Transparency Data

Blood test, lipase

Facility: Texoma Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $164
  • Cash Discount Price: $438
  • vs. Medicare Baseline: 23.80x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Texoma Medical Center is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $438. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 23.80x the Medicare baseline. Located in 5016 S Us Highway 75, Denison, TX.
Cash / Self-Pay
$438

Average discount available for prompt cash payment at this facility.

Insurance Median
$164

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: $438 (6357%)
Insurance Median: $164 (2380%)
Cash: $438 (6357% of Medicare)
Ins. Median: $164 (2380% 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 2380% of the Medicare baseline (a markup of 2280%). 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
Molina $6 - $415 87%
Superior $6 - $13 87%
Tchp $6 87%
Amerigroup $9 131%
United_Healthcare $9 131%
Aetna $164 2380%
Cigna $216 - $232 3135%
Healthsmart $340 - $438 4935%
Humana $340 4935%
Multiplan $415 6023%
Healthchoice $438 6357%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5016 S Us Highway 75, Denison, TX 75020
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals