CMS Price Transparency Data

Blood test, lipase

Facility: Bellin Health Oconto Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $27
Cash Discount Price: $25
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Bellin Health Oconto Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.92x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$27

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: $25 (363%)

Insurance Median: $27 (392%)

Cash: $25 (363% of Medicare)

Ins. Median: $27 (392% 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 392% of the Medicare baseline (a markup of 292%). 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	$13 - $14	189%
Community Care	$13	189%
Humana	$13	189%
My Choice	$13	189%
Network Health	$13 - $32	189%
UnitedHealthcare	$16 - $27	232%
Aetna	$19	276%
Cigna	$27	392%
Chorus Community Health Plan	$28	406%
Common Ground	$28	406%
Aspirus Arise	$30	435%
Healthsmart	$30	435%
Ihs(Claimsbridge)	$30	435%
Medical College Of Wi	$30	435%
Hps/Paymedix	$31 - $34	450%
Allied National	$32	464%
First Health	$32	464%
Galaxy Health	$32	464%
Wps Insurance	$32	464%
Three Rivers Provider Network	$34	493%
Trilogy	$34	493%

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 $25.
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 Bellin Health Oconto 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.