CMS Price Transparency Data

Blood test, lipase

Facility: Community Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $83
Cash Discount Price: $66
vs. Medicare Baseline: 12.05x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Community Memorial Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 12.05x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $66 (958%)

Insurance Median: $83 (1205%)

Cash: $66 (958% of Medicare)

Ins. Median: $83 (1205% 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 1205% of the Medicare baseline (a markup of 1105%). 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 - $84	102%
Allwell	$7	102%
Blue Cross Blue Shield	$7 - $34	102%
Care Wisconsin/Mychoice	$7	102%
Community Care	$7	102%
Health Partners	$7 - $78	102%
Humana	$7	102%
Icare	$7	102%
Network Health Plan	$7 - $8	102%
Security Health Plan	$7	102%
UnitedHealthcare	$7 - $40	102%
Sheboygan Employers Health Network	$8	116%
Centivo	$36 - $40	522%
Froedtert South	$50	726%
Chorus Community Health Plan	$52	755%
Common Ground	$72	1045%
Health Payment Systems	$83	1205%
Trilogy	$83	1205%
Wisconsin Physician Services	$84	1219%
Aspirus	$96	1393%
Ibsi Passport	$97	1408%
Americas Choice	$104	1509%
Federated Mutual	$104	1509%
Healtheos	$104	1509%
Multiplan/Private Healthcare Systems	$104	1509%
Savility	$104	1509%
Cigna	$106	1538%
First Health Network	$106	1538%
Healthsmart	$108	1567%
Physicians Plus	$108	1567%

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 $66.
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 Community Memorial 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.