CMS Price Transparency Data

Blood test, lipase

Facility: Seneca District Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83690
Insurance Median: $114
Cash Discount Price: $96
vs. Medicare Baseline: 16.55x Medicare

The contracted insurance negotiated median rate for a Blood test, lipase at Seneca District Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 16.55x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $96 (1393%)

Insurance Median: $114 (1655%)

Cash: $96 (1393% of Medicare)

Ins. Median: $114 (1655% 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 1655% of the Medicare baseline (a markup of 1555%). 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
Amthem Bc Mcal	$8	116%
Medi-Cal	$8	116%
Partnership Hp-All Plans	$8	116%
Ambetter / Centene	$10	145%
UnitedHealthcare	$46 - $118	668%
Tricare	$84	1219%
Imperial Hp Ma-All Plans	$95	1379%
Blue Cross Blue Shield	$99 - $108	1437%
Blue Shield Ipf/Ca Exchange	$107	1553%
Beech Street Corp- All Plans	$114	1655%
Cigna	$114	1655%
Integrated Hp-All Plans	$114	1655%
Interplan Corp- All Plans	$114	1655%
Medincrease- All Plans	$114	1655%
Multiplan- All Plans	$114	1655%
Pacificare - All Plans	$114	1655%
Provider Ntwrk Of America-All Plans	$114	1655%
Alliance- All Plans	$117	1698%
Community Care Network - All Plans	$117	1698%
Coventry- All Plans	$118	1713%
Northern Nevada Health Network- All Plans	$118	1713%
Superior California Ppo - All Plans	$118	1713%
Blue Shield Of Ca- All Other Plans	$119	1727%
Healthnet - All Other Plans	$119	1727%
Three Rivers- All Plans	$119	1727%

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 $96.
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 Seneca District 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.