CMS Price Transparency Data

Blood test, lipase

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $14
Cash Discount Price: $49
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Baylor Scott & White Medical Center - Marble Falls is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.03x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $49 (711%)

Insurance Median: $14 (203%)

Cash: $49 (711% of Medicare)

Ins. Median: $14 (203% 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 203% of the Medicare baseline (a markup of 103%). 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 Health Plan	$3 - $26	44%
American Health Plan	$7	102%
Baylor Scott & White Health Plan	$7 - $62	102%
Blue Cross Blue Shield	$7 - $41	102%
Corvel	$7	102%
Healthspring	$7	102%
Humana	$7 - $101	102%
Prime Health Services	$7	102%
Procare Advantage	$7	102%
Triwest	$7	102%
UnitedHealthcare	$8 - $9	116%
Aetna	$10 - $79	145%
Cigna	$10 - $87	145%
Midcoast	$10 - $79	145%
Quiktrip	$10 - $79	145%
Sedgwick	$10	145%
Independent Medical System	$11 - $87	160%
University Of Mary Hardin-Baylor	$11 - $84	160%
Curative	$12 - $94	174%
First Health	$13 - $101	189%
Healthsmart	$13 - $108	189%
Bluebell Creameries	$14 - $108	203%
Private Health Care System	$14 - $108	203%
Three Rivers	$17 - $130	247%

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 $49.
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 Baylor Scott & White Medical Center - Marble Falls 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.