CMS Price Transparency Data

Blood test, lipase

Facility: Alhambra Hospital Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $17
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Alhambra Hospital Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.47x the Medicare baseline. Located in 100 S Raymond Ave, Alhambra, CA.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $56 (813%)
Insurance Median: $17 (247%)
Cash: $56 (813% of Medicare)
Ins. Median: $17 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
Stewart Mg Senior Hmo $5 73%
Ahmc-Reciprocity-Medi-Cal/Healthy Families $6 87%
Blue Shield 65 Plus $6 87%
Citrus Valley Health Partners $6 87%
Kaiser Medi-Cal $6 87%
La Care Pasc Seiu Misc $6 87%
Miscellaneous Medi-Cal Hmo $6 87%
Aetna $7 - $12 102%
Alignment Senior Hmo $7 102%
Allied Physicians Of Ca Medi-Cal $7 102%
Altamed Senior Services $7 102%
Apa Aco $7 102%
Blue Cross Blue Shield $7 - $13 102%
Brand New Day Sr $7 102%
Central Health Plan Of Ca Senior Hmo $7 102%
Health Net Medi-Cal $7 102%
Health Net Senior Hmo $7 102%
Humana $7 102%
La Care Exchange $7 102%
La Care Medi-Cal Hmo $7 102%
Medi-Cal $7 102%
Medicare (plans) $7 - $247 102%
Miscellaneous Senior Hmo $7 102%
UnitedHealthcare $7 - $14 102%
Wellcare Senior Hmo $7 102%
Cigna $8 - $185 116%
Health Net Exchange $8 116%
Health Net Salud Con Hmo $8 116%
Miscellaneous Work Comp Hmo $8 116%
Molina Exchange $8 116%
Tricare $8 116%
Ahmc Health $10 145%
Allied Physicians Of Ca Commercial $10 145%
Ahmc-Reciprocity-Comm/Senior $12 - $124 174%
Allied Physicians Comm/Sr $14 - $144 203%
Allied Physicians Medi-Cal $14 - $144 203%
Health Net Ppo/Epo/Pos $14 203%
Wellcare Allied Senior Hmo $14 - $144 203%
Molina Health Plan $16 - $161 232%
Self Pay $17 - $165 247%
Health Net Exchange Enhanced Ppo $18 - $175 261%
Kaiser Commercial $26 - $255 377%
Scan Senior Plan $27 - $268 392%
Multiplan $33 - $330 479%
Miscellaneous Commercial Ppo/Hmo $41 - $412 595%
Blue Shield Value Network Exchange $86 1248%
Blue Shield Hmo/Ppo $96 1393%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 S Raymond Ave, Alhambra, CA 91801
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals