CMS Price Transparency Data

Blood test, lipase

Facility: Texas Childrens Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $57
Cash Discount Price: $76
vs. Medicare Baseline: 8.27x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Texas Childrens Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.27x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $76 (1103%)

Insurance Median: $57 (827%)

Cash: $76 (1103% of Medicare)

Ins. Median: $57 (827% 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 827% of the Medicare baseline (a markup of 727%). 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
Superior Chip	$7	102%
Driscoll Children'S Health Plan Mcd	$8	116%
Community Health Choice	$12 - $97	174%
First Care Health Plan	$21 - $97	305%
UnitedHealthcare	$21 - $97	305%
Molina Mcd	$23 - $46	334%
Blue Cross Blue Shield	$27 - $96	392%
Community First Health Plan Mcd	$30 - $61	435%
Cook Children'S Health Plan	$30 - $61	435%
Cigna	$43 - $97	624%
Aetna	$49 - $97	711%
Kelseycare	$49 - $99	711%
Healthsmart	$53 - $106	769%
Evolutions Healthcare	$57 - $114	827%
First Health	$67 - $144	972%
Multiplan	$68 - $137	987%
Galaxy Health Network	$72 - $144	1045%

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 $76.
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 Texas Childrens Hospital 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.