CMS Price Transparency Data

Blood test, lipase

Facility: Marshfield Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $69
Cash Discount Price: $77
vs. Medicare Baseline: 10.01x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Marshfield Medical Center is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.01x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $77 (1118%)

Insurance Median: $69 (1001%)

Cash: $77 (1118% of Medicare)

Ins. Median: $69 (1001% 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 1001% of the Medicare baseline (a markup of 901%). 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
Blue Cross Blue Shield	$7 - $43	102%
Group Health Cooperative Of Eau Claire	$7 - $75	102%
Security Health Plan (Shp)	$7 - $47	102%
Veteran'S Administration (Va Ccn)	$7	102%
Managed Health Services	$8	116%
UnitedHealthcare	$24	348%
Family Health Center (Fhc)	$40	581%
Amish/Mennonite	$45	653%
Sanford Health Plan	$45	653%
The Alliance	$56 - $68	813%
Besse Forest Products	$69	1001%
Molina Healthcare Of Wi	$69	1001%
Rice Lake School District	$69	1001%
Wps Health Insurance	$71 - $78	1030%
Trilogy	$73 - $78	1060%
Medica Of Wi	$75 - $77	1089%
Cigna	$76	1103%
Healtheos By Multiplan Inc.	$76 - $77	1103%
Corvel	$77	1118%
First Health	$77	1118%
Health Partners	$77	1118%
Three Rivers Provider Network (Trpn)	$77	1118%
Coventry	$78	1132%
Health Smart	$78	1132%
Rising Medical Work Comp	$79	1147%

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 $77.
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 Marshfield 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.