CMS Price Transparency Data

Blood test, lipase

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $63
Cash Discount Price: $65
vs. Medicare Baseline: 9.14x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at University of Wi Hospitals & Clinics Authority is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 9.14x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $65 (943%)

Insurance Median: $63 (914%)

Cash: $65 (943% of Medicare)

Ins. Median: $63 (914% 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 914% of the Medicare baseline (a markup of 814%). 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
Aetna	$7 - $87	102%
Blue Cross Blue Shield	$7 - $104	102%
Humana	$7	102%
Medicare (plans)	$7	102%
UnitedHealthcare	$7 - $68	102%
Alliance_Premier_Network	$52	755%
Mercycare	$54	784%
Triology	$56 - $66	813%
Security_Health_Plan	$59 - $69	856%
Employer'S_Coalition_On_Health	$60 - $84	871%
Alliance	$61	885%
Hfn	$62 - $84	900%
United_Healthcare	$62 - $93	900%
Beloit_Health_System	$63	914%
Aspirus_Health_Plan	$64	929%
Cigna	$65	943%
Health_Partners_Insurance	$66	958%
Health_Payment_Systems	$67	972%
Dean_Health_Plan	$70	1016%
Medical_Associates	$72	1045%
Employers_Healthcare_Coalition_Of_Wi	$76	1103%
Wps	$76 - $83	1103%
Aspirus_Network_Inc	$84	1219%
Chorus_Community	$87	1263%
Ghc_Eau_Claire_Health_Plan	$87	1263%
Multiplan	$87 - $100	1263%
Sheybogan_Employers_Health_Network	$87	1263%
Coventry	$93	1350%
Dean_Care	$93	1350%
Healthsmart	$96	1393%

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 $65.
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 University of Wi Hospitals & Clinics Authority 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.