CMS Price Transparency Data

Blood test, lipase

Facility: Ventura County Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $16
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Ventura County Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.32x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $46 (668%)
Insurance Median: $16 (232%)
Cash: $46 (668% of Medicare)
Ins. Median: $16 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Tricare $2 - $11 29%
Vchcp-All Plans $6 - $29 87%
Alignment Hp - All Plans $7 102%
Blue Shield Mcr Adv $7 102%
Healthnet Mcr Adv $7 102%
Humana $7 102%
UnitedHealthcare $7 - $84 102%
Americas Hp Mcr Adv Ip/Op Only $8 116%
Clinicas Mcr Adv $8 116%
Hpn Ip/Op Only Medi-Cal $8 116%
Kaiser Medi-Cal Ip/Op Only $8 116%
Medi-Cal $8 116%
Scan-All Plans $8 116%
Clinicas Comm - All Other Plans $9 131%
Imperial-All Plans $9 131%
Kaiser Mcal Pediatric Ip/Op Only $9 131%
Ntwrk Provdrs-All Plans $9 131%
Western Growers-All Plans $9 131%
Americas Hp Comm Ip/Op Only-All Other Plans $10 145%
Americas Hp Mcal Ip/Op Only $10 145%
Clinicas Mcal $10 145%
Blue Shield Epn $12 - $60 174%
Cigna $13 189%
Gold Coast Medi-Cal-All Plans $14 203%
Healthnet Comm-All Other Plans $16 - $85 232%
Kaiser Comm Pediatric Ip/Op Only $16 - $85 232%
Aetna $17 - $154 247%
Blue Cross Blue Shield $18 - $142 261%
Blue Shield Comm - All Other Plans $23 334%
Multiplan/Claritev-All Plans $24 - $123 348%
Three Rivers Ip/Op Only-All Plans $24 - $123 348%
Ppo Next Ip/Op Only-All Plans $27 - $139 392%
Kaiser Mcr Pediatric Ip/Op Only $30 - $154 435%
Medicare (plans) $30 - $154 435%
Hpn Comm Ip/Op Only-All Other Plans $43 - $219 624%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals