CMS Price Transparency Data

Blood test, lipase

Facility: Unitypoint Health - Meriter

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $36
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 5.22x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Unitypoint Health - Meriter is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.22x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $92 (1335%)
Insurance Median: $36 (522%)
Cash: $92 (1335% of Medicare)
Ins. Median: $36 (522% 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 522% of the Medicare baseline (a markup of 422%). 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
UnitedHealthcare $4 - $47 58%
Aspirus $7 - $69 102%
Blue Cross Blue Shield $7 - $109 102%
Humana $7 102%
Illinicare $7 102%
Meridiancare $7 102%
Prevea 360 $7 - $98 102%
Wellmark Uph Self-Funded $7 - $66 102%
Health Partners Open Network $11 - $42 160%
Cigna $31 - $34 450%
Security Health Plan $33 - $36 479%
Quartz $36 522%
Mercy Care $38 - $39 552%
Medical Associates Health Plan $41 595%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals