CMS Price Transparency Data

Blood test, lipase

Facility: Adventist Health Clearlake

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $73
Cash Discount Price: $87
vs. Medicare Baseline: 10.60x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Adventist Health Clearlake is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 10.60x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $87 (1263%)

Insurance Median: $73 (1060%)

Cash: $87 (1263% of Medicare)

Ins. Median: $73 (1060% 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 1060% of the Medicare baseline (a markup of 960%). 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
Blue Cross Blue Shield	$1 - $80	15%
Blue Shield Mcr Adv	$1 - $73	15%
Kaiser Mcr Adv	$1 - $73	15%
Tricare	$1 - $73	15%
Ah Employee Health Plan - All Plans	$3 - $146	44%
Aetna	$5 - $260	73%
Blue Shield Epn - All Other Plans	$5 - $267	73%
Blue Shield Non-Epn	$5 - $267	73%
Cigna	$5 - $313	73%
First Health- All Plans	$5 - $278	73%
Foundation- All Plans	$5 - $296	73%
Health Mgmt Network- All Plans	$5 - $296	73%
Healthnet- All Plans	$5 - $285	73%
Humana	$5 - $296	73%
Interplan- All Plans	$5 - $313	73%
Kaiser- All Other Plans	$5 - $313	73%
Phcs- All Plans	$5 - $296	73%
Three Rivers Provider Network- All Plans	$5 - $313	73%
UnitedHealthcare	$5 - $290	73%
Western Growers- All Plans	$5 - $261	73%
Bc Managed Mcal	$6 - $8	87%
Medi-Cal	$6 - $8	87%
Partnership Mcal - All Plans	$6 - $8	87%

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 $87.
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 Adventist Health Clearlake 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.