CMS Price Transparency Data

Blood test, lipase

Facility: Forks Community Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $109
Cash Discount Price: $166
vs. Medicare Baseline: 15.82x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Forks Community Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.82x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $166 (2409%)

Insurance Median: $109 (1582%)

Cash: $166 (2409% of Medicare)

Ins. Median: $109 (1582% 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 1582% of the Medicare baseline (a markup of 1482%). 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
UnitedHealthcare	$14 - $177	203%
Medicaid / KanCare	$72 - $76	1045%
Coordinated Care (Mco) Mcd-All Plans	$78	1132%
Community Health Network Mcr-All Other Plans	$94	1364%
Humana	$94	1364%
Tricare	$94	1364%
Triwest-All Plans	$94	1364%
Ambetter / Centene	$109	1582%
Wellcare Med Adv - All Plans	$109	1582%
Regence-All Other Plans	$120	1742%
Community Health Exchange	$135	1959%
Molina Commercial-All Other Plans	$191	2772%
Aetna	$198	2874%
Blue Cross Blue Shield	$198	2874%
Cigna	$208	3019%
First Choice-All Plans	$208	3019%
Medicare (plans)	$318	4615%

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 $166.
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 Forks Community Hospital 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.