CMS Price Transparency Data

Blood test, lipase

Facility: Primary Children's Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $31
  • Cash Discount Price: $33
  • vs. Medicare Baseline: 4.50x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Primary Children's Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 4.50x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$33

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $33 (479%)
Insurance Median: $31 (450%)
Cash: $33 (479% of Medicare)
Ins. Median: $31 (450% 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 450% of the Medicare baseline (a markup of 350%). 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
Health Plan Of Nevada $6 - $7 87%
Tricare $6 87%
Triwest $6 87%
American Health $7 - $25 102%
Healthy U $7 102%
Molina $7 - $37 102%
Selecthealth $7 - $37 102%
Southwest Behavioral Health $7 102%
UnitedHealthcare $7 - $37 102%
Donor Connect $16 - $18 232%
Aetna $31 - $38 450%
Awh Connected $31 - $38 450%
Byu Athletics $31 - $37 450%
Campbell Scientific $31 - $37 450%
Cigna $31 - $37 450%
Deseret Mutual $31 - $37 450%
Emi $31 - $37 450%
Emi Health $31 - $37 450%
First Choice $31 - $37 450%
First Choice Of The Midwest $31 - $37 450%
Franklin County $31 - $37 450%
Global Excel $31 - $37 450%
Health Utah $31 - $37 450%
Humana $31 - $37 450%
Hygeia Corporation $31 - $37 450%
Ifit $31 - $37 450%
Juniper Systems $31 - $37 450%
Lw Miller $31 - $37 450%
Managed Care Admin $31 - $37 450%
Medcare International $31 - $37 450%
Motivhealth $31 - $37 450%
Pehp $31 - $37 450%
Prodegi Corp Benefit $31 - $37 450%
Tanner Llc $31 - $37 450%
Uofu $31 - $37 450%
Utah Tech $31 - $37 450%
Wise Network $31 - $37 450%
Blue Cross Blue Shield $32 - $38 464%
First Health $32 - $38 464%
Springtide $32 - $38 464%
Utah Behavioral Health Network $36 522%
Altius Mhnet Behavioral Health $39 566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens