CMS Price Transparency Data

Blood test, lipase

Facility: Methodist Hospital Stone Oak

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $15
  • Cash Discount Price: $362
  • vs. Medicare Baseline: 2.18x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Methodist Hospital Stone Oak is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $362. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 2.18x the Medicare baseline. Located in 1139 E Sonterra Blvd,, San Antonio, TX.
Cash / Self-Pay
$362

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $362 (5254%)
Insurance Median: $15 (218%)
Cash: $362 (5254% of Medicare)
Ins. Median: $15 (218% 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 218% of the Medicare baseline (a markup of 118%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Superior Health $5 - $31 73%
Aetna $6 - $7 87%
Amerigroup $6 - $88 87%
Community First Health Plans $6 - $169 87%
Molina Healthcare $6 - $11 87%
United $6 - $281 87%
Usa Managed Care Chip $6 87%
American Health Plan Of Texas $7 102%
Blue Cross Blue Shield $7 - $184 102%
Clover Insurance $7 102%
Devoted Health $7 102%
Gonzaba Medical Group $7 102%
Humana $7 102%
Ilumed $7 102%
Integranet $7 102%
Lighthouse Hospice $7 102%
Texas Independent Health Plan $7 102%
Triwest $7 102%
Triwest Health Alliance $7 102%
Triwest Va Pccc $7 102%
UnitedHealthcare $7 102%
Value Options $7 102%
Wellcare $7 102%
Wellmed $7 102%
Focus Healthcare Management $10 145%
Cigna $11 - $15 160%
Superior $11 160%
Focus Health Solutions $16 232%
Healthcare Highways $16 232%
Oscar $18 261%
Imperial Insurance $19 - $119 276%
Valenz $34 - $219 493%
Evry Health $36 - $230 522%
Fidelis Securecare $44 - $281 639%
National Choicecare $49 - $312 711%
Texas Healthcare Foundation Heb $49 - $312 711%
Tx Healthcare Foundation $49 - $312 711%
Healthsmart Preferred Care $54 - $344 784%
Independent Medical Systems $54 - $344 784%
Physician Cooperative Of Texas $54 - $344 784%
Haa Preferred Partners $59 - $375 856%
San Antonio Employers Health Alliance $59 - $375 856%
Coastal Comp Health Networks $64 - $406 929%
National Healthcare Solutions $64 - $406 929%
Tml Intergovernmental Ebp $69 - $438 1001%
Multiplan $74 - $531 1074%
Usa Managed Care $74 - $469 1074%
Blue Bell $78 - $500 1132%
Directcare America $78 - $500 1132%
Managed Healthcare $83 - $531 1205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1139 E Sonterra Blvd,, San Antonio, TX 78258
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals