CMS Price Transparency Data

Blood test, lipase

Facility: Holy Family Memorial

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $38
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 5.52x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Holy Family Memorial is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.52x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $40 (581%)
Insurance Median: $38 (552%)
Cash: $40 (581% of Medicare)
Ins. Median: $38 (552% 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 552% of the Medicare baseline (a markup of 452%). 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
Allwell $7 102%
Blue Cross Blue Shield $7 - $9 102%
Community Care Incorporated $7 102%
Health Partners $7 - $47 102%
Humana $7 102%
Icare $7 102%
Molina $7 102%
Network Health Plan $7 - $40 102%
Security Health Plan $7 - $58 102%
UnitedHealthcare $7 - $8 102%
Health Payment Systems $17 247%
Chorus Community Health Plan $20 290%
Medical College Of Wisconsin $24 348%
Centivo $29 - $33 421%
Dean Health Plan $36 522%
Sheboygan Employers Health Network $43 624%
Trilogy $48 697%
Cigna $52 755%
Wps Health Plan $53 769%
Aspirus $58 842%
Healtheos $58 842%
Multiplan/Private Healthcare Systems $58 842%
Preferred One $58 842%
Healthsmart $60 871%
First Health Network $63 914%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals