CMS Price Transparency Data

Blood test, lipase

Facility: Memorialcare Saddleback Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $12
Cash Discount Price: $26
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Memorialcare Saddleback Medical Center is $12. 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 1.74x the Medicare baseline. Located in 24451 Health Center Drive, Laguna Hills, CA.

Cash / Self-Pay

$26

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $12 (174%)

Cash: $26 (377% of Medicare)

Ins. Median: $12 (174% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Select Health	$4 - $9	58%
Seoul Medical Group	$6	87%
UnitedHealthcare	$6	87%
Aetna	$7	102%
Blue Cross Blue Shield	$7 - $25	102%
Blue Shield	$7 - $73	102%
Easy Choice	$7	102%
Central Health	$8	116%
Clever Care	$8	116%
Monarch Health Plan	$9 - $17	131%
Cigna	$11 - $16	160%
Centivo	$16	232%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $26.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83690.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorialcare Saddleback Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83690.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.