CMS Price Transparency Data

Blood test, lipase

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $187
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 27.14x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Carilion Stonewall Jackson Hospital is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 27.14x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$187

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: $102 (1480%)
Insurance Median: $187 (2714%)
Cash: $102 (1480% of Medicare)
Ins. Median: $187 (2714% 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 2714% of the Medicare baseline (a markup of 2614%). 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
Blue Cross Blue Shield $7 102%
Sentara Health Plan $7 - $180 102%
Abh of VA (Formerly Coventry) $8 116%
Abh of Wva (Formerly Coventry) $8 116%
Humana $8 116%
UnitedHealthcare $8 - $238 116%
Aetna $148 - $193 2148%
Gateway - Tier 3 $160 2322%
Vhn - Ultra $180 2612%
Connecticare $204 2961%
Cigna $233 3382%
Gateway - Tier 2 $233 3382%
Vhn - Plus $233 3382%
Integrated Health Plan $247 3585%
Vhn $247 3585%
Vhn - Link $262 3803%
Beech Street $268 3890%
Gateway - Tier 1 $276 4006%
Vhn - Secondary Payors $276 4006%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals