CMS Price Transparency Data

Blood test, lipase

Facility: Adventist Health Sonora

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $70
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 10.16x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Adventist Health Sonora is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.16x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $26 (377%)
Insurance Median: $70 (1016%)
Cash: $26 (377% of Medicare)
Ins. Median: $70 (1016% 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 1016% of the Medicare baseline (a markup of 916%). 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
Kaiser - All Plans $3 - $291 44%
UnitedHealthcare $3 - $500 44%
Western Growers/Pinnacle - All Plans $3 - $308 44%
Affordable Health - All Plans $5 - $524 73%
Beech Street- All Plans $5 - $495 73%
Blue Shield - All Other Plans $5 - $442 73%
Blue Shield Epn $5 - $441 73%
Greatwest Oa/Pos/Hmo $5 - $495 73%
Greatwest Ppo - All Other Plans $5 - $524 73%
Healthnet - All Other Plans $5 - $510 73%
Interplan - All Plans $5 - $524 73%
Multiplan - All Plans $5 - $524 73%
Phcs Ppo - All Plans $5 - $524 73%
Trpn - Three Rivers Ppo - All Plans $5 - $466 73%
Celtic Ca Hlth Well Mcal - All Plans $6 - $11 87%
Central Ca Alliance Ccs Mcal $6 - $9 87%
Central Ca Alliance Chdp Mcal $6 - $9 87%
Central Ca Alliance Mcal $6 - $9 87%
Cigna $6 - $553 87%
Healthnet Mcal $6 - $12 87%
Medi-Cal $6 - $8 87%
Stanilaus Foundation - All Plans $6 - $553 87%
Aetna $7 - $70 102%
Blue Shield Mcare $7 102%
Healthnet Mcr Adv $7 102%
Phs Prime Health Srvcs-All Plans $7 102%
Tricare $7 102%
Ah Employee Health Plan - All Plans $12 174%
Bc Exchange $63 914%
Bc Non-Mcs - All Other Plans $70 1016%
Bc Mcs $83 1205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals