CMS Price Transparency Data

Blood test, lipase

Facility: Texas Scottish Rite Hospital for Children

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $69
Cash Discount Price: $157
vs. Medicare Baseline: 10.01x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Texas Scottish Rite Hospital for Children is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.01x the Medicare baseline. Located in 2222 Welborn Street, Dallas, TX.

Cash / Self-Pay

$157

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $157 (2279%)

Insurance Median: $69 (1001%)

Cash: $157 (2279% of Medicare)

Ins. Median: $69 (1001% 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 1001% of the Medicare baseline (a markup of 901%). 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	$7 - $71	102%
Tricare	$8	116%
Blue Cross Blue Shield	$22 - $69	319%
Children Med Center Health Plan - All Plans	$69	1001%
Community First Health Plan-All Plans	$69	1001%
Cook Childrens Hp-All Plans	$69	1001%
Driscoll Childrens-All Plans	$69	1001%
Medicaid / KanCare	$69	1001%
Molina Commercial - All Other Plans	$69	1001%
Soonercare-All Plans	$69	1001%
UnitedHealthcare	$69 - $102	1001%
Firstcare Health Mcaid	$73	1060%
Tx Childrens Hlth Mcaid-All Plans	$73	1060%
Firstcare Health Comm - All Other Plans	$110	1597%
Cigna	$118	1713%
Healthscope - All Plans	$118	1713%
Scott & White Comm- All Other Plans	$118	1713%

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 $157.
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 Scottish Rite Hospital for Children 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.