CMS Price Transparency Data

Blood test, lipase

Facility: Graham Regional Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $34
Cash Discount Price: $62
vs. Medicare Baseline: 4.93x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Graham Regional Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 4.93x the Medicare baseline. Located in 1301 Montgomery Road, Graham, TX.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $62 (900%)

Insurance Median: $34 (493%)

Cash: $62 (900% of Medicare)

Ins. Median: $34 (493% 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 493% of the Medicare baseline (a markup of 393%). 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
Amerigroup	$14 - $23	203%
Choicecare Network	$14 - $23	203%
Superior Healthplan	$14 - $23	203%
Wellpoint	$18 - $32	261%
Aetna	$29 - $51	421%
Cigna	$29 - $51	421%
Blue Cross Blue Shield	$31 - $59	450%
Three Rivers Provider Network	$38 - $66	552%
Health Advantage Network	$41 - $70	595%
Healthsmart Preferred Care	$41 - $70	595%
Curative	$72 - $125	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 $62.
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 Graham Regional Medical Center 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.