CMS Price Transparency Data

Blood test, lipase

Facility: Astria Sunnyside Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $105
Cash Discount Price: $107
vs. Medicare Baseline: 15.24x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Astria Sunnyside Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 15.24x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $107 (1553%)

Insurance Median: $105 (1524%)

Cash: $107 (1553% of Medicare)

Ins. Median: $105 (1524% 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 1524% of the Medicare baseline (a markup of 1424%). 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
Medicare (plans)	$6 - $7	87%
Aetna	$7 - $165	102%
Healthcomp_Ihs	$7	102%
Humana	$7 - $169	102%
Tricare	$7	102%
Va	$7	102%
Medicaid / KanCare	$46 - $58	668%
Molina	$46	668%
Regence	$97	1408%
Cigna	$113	1640%
Li	$115	1669%
First_Choice	$141	2046%
Tpsc	$147	2134%
Kaiser	$148	2148%
Premera	$153	2221%
UnitedHealthcare	$160	2322%
Fhpw	$165	2395%
Healthcomp	$169	2453%
Bcchp	$188	2729%
Great_Rivers	$188	2729%
Zenith	$188	2729%

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 $107.
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 Astria Sunnyside 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.