CMS Price Transparency Data

Blood test, lipase

Facility: San Antonio Regional Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $22
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at San Antonio Regional Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 3.19x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$22

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: $185 (2685%)
Insurance Median: $22 (319%)
Cash: $185 (2685% of Medicare)
Ins. Median: $22 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Healthnet Medi-Cal $6 87%
Blue Cross Blue Shield $7 - $277 102%
Blue Shield Mcr Adv $7 102%
Caremore Mcr Adv - All Plans $7 102%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $7 102%
Healthnet Mcr Adv $7 102%
Humana $7 102%
Iehp Mcr Adv $7 102%
Inter Valley Hp Mcr Adv- All Plans $7 102%
Kasiser Mcr Adv $7 102%
Kindred Mcr Adv-All Plans $7 102%
Molina Mcr Adv $7 102%
Scan Health Plan Mcr Adv-All Plans $7 102%
Tricare $7 102%
Universal Care - All Plans $7 102%
Zelis Mcr Adv $7 102%
Imperial Health Mcr Adv-All Plans $8 116%
Kaiser Medi-Cal $8 116%
Medi-Cal $8 116%
Aetna $9 - $633 131%
Alpha Care Mg Mcal/Hlthy Kids $9 131%
Choice Phycn Ntwrk Op Only $9 131%
Heritage Prov Ntwrk/Regal Mcal $9 131%
Molina Exchange-All Other Plans $9 131%
Molina Medi-Cal $9 131%
Iehp Comm - All Other Plans $10 145%
Iehp Mcal $10 145%
Redlands Employee $10 145%
Redlands Hmo-All Other Plans $11 160%
Prime Health - All Plans $12 174%
Healthnet - All Other Plans $16 232%
Blue Shield Epn $19 276%
Kaiser Comm - All Other Plans $19 276%
Cigna $25 363%
UnitedHealthcare $44 - $201 639%
Ambetter / Centene $115 1669%
Epic Health Plan - All Other Plans $190 2758%
Blue Shield Hmo Pos / Calpers Ppo $234 3396%
Blue Shield Epo Ppo - All Other Plans $254 3687%
Pc Inland Valley Scan $316 4586%
Pc Inland Valley-All Other Plans $316 4586%
Coventry Ccn/First Hlth - All Plans $348 5051%
Choicecare Ntwrk-All Plans $456 6618%
Multiplan/Phcs - All Plans $456 6618%
Networks By Design - All Plans $475 6894%
Zelis Comm-All Other Plans $475 6894%
Foundation Inland Epo-All Other Plans $506 7344%
Foundation Inland Ppo $538 7808%
Health Payors - All Plans $570 8273%
Interplan - All Plans $570 8273%
Wellcare/Easy Choice-All Plans $620 8999%
Alpha Care Mg Mcr Adv $633 9187%
Central Hlth Plan Mcr Adv-All Plans $633 9187%
Epic Health Plan Mcr Adv $633 9187%
Prospect Hp-All Plans $633 9187%
Providence Clevercare Mcr Adv $633 9187%
Heritage Prov Ntwrk/Regal Mcr Adv $642 9318%
Clever Care Mcr Adv - All Plans $665 9652%
La Salle Hp Mcr Adv-All Plans $665 9652%
Providence Oscar-All Other Plans $665 9652%
Alpha Care Mg-All Other Plans $791 11480%
Heritage Prov Ntwrk/Regal - All Other Plans $1,163 16880%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals