CMS Price Transparency Data

Blood test, lipase

Facility: Mayers Memorial Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $70
Cash Discount Price: $82
vs. Medicare Baseline: 10.16x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Mayers Memorial Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.16x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$82

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: $82 (1190%)

Insurance Median: $70 (1016%)

Cash: $82 (1190% 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.

Consult Patient Advocate

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
Medi-Cal	$8	116%
Partnership Hp-All Plans	$8	116%
Blue Shield Ca Va	$51	740%
Blue Shield Mcr Adv	$51	740%
Arcadian Health Services-All Plans	$54	784%
Health Net Mcr Adv	$54	784%
Tricare	$54	784%
Blue Cross Blue Shield	$55 - $70	798%
Health Net Prison	$59	856%
Imperial Health Plan-All Plans	$61	885%
Blue Shield Ca Exchange	$70	1016%
Blue Shield-All Other Plans	$78	1132%
Cigna	$78	1132%
Corvel Ppo-All Plans	$78	1132%
Coventry/First Health-All Plans	$78	1132%
Hmn-All Plans	$78	1132%
Integrated Hp-All Plans	$78	1132%
Interplan-All Plans	$78	1132%
Multiplan Phcs-All Plans	$78	1132%
Pfmc-All Plans	$78	1132%
Superior Ca-All Plans	$78	1132%
Health Net-All Other Plans	$82	1190%
Pacificare-All Plans	$82	1190%

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 $82.
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 Mayers Memorial Hospital 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.