CMS Price Transparency Data

Blood test, lipase

Facility: Saint Agnes Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $39
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Saint Agnes Medical Center is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.66x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $57 (827%)
Insurance Median: $39 (566%)
Cash: $57 (827% of Medicare)
Ins. Median: $39 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Allegiance $2 - $75 29%
American Postal Workers Secondary $2 - $75 29%
Cba Network By Design $2 - $73 29%
Cigna $2 - $75 29%
Coventry $2 - $67 29%
Healthnet $2 - $79 29%
Network Health $2 - $73 29%
St Agnes Nicu Valley Childrens Hospital $2 - $63 29%
Interplan $3 - $87 44%
Multiplan $3 - $81 44%
Phcs $3 - $81 44%
Aetna $7 - $42 102%
Blue Cross Blue Shield $7 - $64 102%
Humana $7 102%
Medicare (plans) $7 102%
UnitedHealthcare $7 - $14 102%
Welbe Health $7 102%
Align Senior Care $8 116%
Correctcare Integrated Health $9 131%
Medi-Cal Healthnet $9 - $11 131%
Geha $12 174%
Kaiser Permanente $12 174%
Advantek Central Usd $17 247%
Blue Shield - Ca $20 - $64 290%
Meritain $39 566%
Trustmark Small Business Benefits $39 566%
Allied Benefit Systems $42 610%
Boon Chapman $42 610%
Hap $42 610%
Webtpa $42 610%
Blue Benefit Administrators Of Massachusetts $64 929%
Blue Care Network $64 929%
Blue Distinction Transplant $64 929%
Blue Shield - Id (Regence) $64 929%
Blue Shield - Ny Highmark Northeastern $64 929%
Blue Shield - Ny Highmark Western $64 929%
Blue Shield - Pa (Highmark) $64 929%
Blue Shield - Wa (Regence) $64 929%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals