Blood test, lipase
Facility: Regional Medical Center
Billing Code: 83690 (CPT)
- CPT Billing Code: 83690
- Insurance Median: $870
- Cash Discount Price: $67
- vs. Medicare Baseline: 126.27x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 12627% of the Medicare baseline (a markup of 12527%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 12627% |
Consumer Guidance & Cost Commentary
For this Blood test, lipase procedure at Regional Medical Center in Manchester, the cash median price is $67. This facility is a Critical Access Hospital with a government-local ownership structure, and while the cash rate is notably lower than the negotiated rate of $870, it remains significantly higher than the state average of $32. Patients with high-deductible plans may find that paying this cash price upfront is more cost-effective than using insurance, as the commercial negotiated rate of $870 far exceeds the cash option.
It is important to note that Medicare benchmarks this service at $6.89, which serves as the objective baseline for evaluating pricing markups. The commercial negotiated rate of $870 averages 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare. Before scheduling, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when payment is made in full upfront. Additionally, because the No Surprises Act prohibits balance billing for non-emergency services at in-network facilities, patients should request a waiver of insurance submission to ensure they are not billed for the difference between the chargemaster and the allowed amount.