CMS Price Transparency Data

Blood test, lipase

Facility: Childrens Medical Center Plano

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $168
  • Cash Discount Price: $180
  • vs. Medicare Baseline: 24.38x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Childrens Medical Center Plano is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 24.38x the Medicare baseline. Located in 7601 Preston Road, Plano, TX.
Cash / Self-Pay
$180

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $180 (2612%)
Insurance Median: $168 (2438%)
Cash: $180 (2612% of Medicare)
Ins. Median: $168 (2438% 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 2438% of the Medicare baseline (a markup of 2338%). 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
Aetna $6 - $168 87%
Humana $6 - $180 87%
Medicaid / KanCare $6 87%
Oklahoma Complete Health $6 87%
Superior Health Plan $7 102%
Firstcare Health $55 798%
Wellpoint $70 1016%
Molina Healthcare $77 1118%
Parkland Community $79 1147%
Texas Children'S Health Plan $79 1147%
Cookchildren'S Health Plan $82 1190%
Carelon $89 - $118 1292%
Blue Cross Blue Shield $96 - $163 1393%
UnitedHealthcare $127 - $180 1843%
Methodist $137 1988%
Cigna $158 - $166 2293%
Employers Health Network $168 2438%
Imagine Health $168 2438%
Scott & White $170 2467%
Txp Emerging Therapy Solutions $170 2467%
Healthsmart $175 - $204 2540%
Healthscope Benefit Solutions $180 2612%
Phcs $180 2612%
Quiktrip (Qt) $180 2612%
Txp Interlink $180 2612%
Coventry Health $192 2787%
Equifax Healthcare $204 2961%
Multiplan $204 2961%
Usa Managed Care $223 3237%
Galaxy Health $233 3382%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7601 Preston Road, Plano, TX 75024
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens