CMS Price Transparency Data

Blood test, lipase

Facility: Charleston Area Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $135
Cash Discount Price: $166
vs. Medicare Baseline: 19.59x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Charleston Area Medical Center is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 19.59x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

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: $166 (2409%)

Insurance Median: $135 (1959%)

Cash: $166 (2409% of Medicare)

Ins. Median: $135 (1959% 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 1959% of the Medicare baseline (a markup of 1859%). 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	$6 - $170	87%
The Health Plan Of West Virginia Inc.	$6 - $168	87%
Unicare Health Plan Of West Virginia Inc.	$6 - $7	87%
Blue Cross Blue Shield	$7 - $158	102%
Choicecare Network	$7 - $170	102%
Optimum Choice Inc.	$7	102%
Triwest Va	$7	102%
UnitedHealthcare	$7 - $170	102%
West Virginia Senior Advantage Inc.	$7	102%
Integrated Medical Solutions	$13	189%
Naphcare	$14	203%
Caresource	$17	247%
Tricare	$95 - $104	1379%
City Of Charleston	$119 - $130	1727%
Cigna	$148 - $161	2148%
Three Rivers Providers Network	$154 - $168	2235%
Healthsmart	$156 - $170	2264%
Multiplan	$156 - $170	2264%

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 $166.
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 Charleston Area Medical Center 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.