CMS Price Transparency Data

Blood test, lipase

Facility: Scripps Mercy Hospital

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $83
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 12.05x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Scripps Mercy Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 12.05x the Medicare baseline. Located in 4077 5Th Ave, San Diego, CA.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

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: $75 (1089%)
Insurance Median: $83 (1205%)
Cash: $75 (1089% of Medicare)
Ins. Median: $83 (1205% 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 1205% of the Medicare baseline (a markup of 1105%). 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 $7 - $174 102%
Alignment Health Plan [443] $7 102%
Astiva Mcr Adv [464] $7 102%
Bc Mcr Adv [830] $7 102%
Blue Cross Blue Shield $7 - $91 102%
Bs Mcr Adv [829] $7 102%
Central Health Mcr Adv [441] $7 102%
Cigna $7 - $120 102%
Clever Care Mcr Adv [465] $7 102%
D-Snp Mcr Adv [889] $7 102%
Dsnp/Csnp - Generic [458] $7 102%
Family Health Centers Pace Mcr Adv Hmo [556] $7 102%
Family Health Centers Pace Medi-Cal [555] $7 102%
Gary And Mary West Pace Medi-Cal Hmo [557] $7 102%
Gpmg/Altura - Mcr Adv [888] $7 102%
Hn Mcr Adv [832] $7 102%
Humana $7 102%
Integrated Health Partners - Mcr Adv [895] $7 102%
Kaiser Northern Ca Region Mcr Adv [386] $7 102%
La Care Mcr Adv Hmo [612] $7 102%
Medicare (plans) $7 102%
Mpmg Mcr Adv [836] $7 102%
Mpmg [800] $7 102%
Ocn Mcr Adv [890] $7 102%
San Diego Pace Medi-Cal [553] $7 102%
Scan Mcr Adv [835] $7 102%
Scan [500] $7 102%
Scan [818] $7 102%
Sharp Comm Med Grp Mcr Adv [840] $7 102%
Sharp Health Plan Mcr Adv [531] $7 102%
Sharp Health Plan Mcr Adv [897] $7 102%
Sharp Rees Stealy Med Grp Mcr Adv [841] $7 102%
St Paul'S Pace Medi-Cal [551] $7 102%
Ucsd Mcr Adv [873] $7 102%
Uh Mcr Adv [831] $7 102%
Uh Palomar Health Mcr Adv [885] $7 102%
UnitedHealthcare $7 - $121 102%
Health Net [340] $11 - $116 160%
Prime Healthcare [614] $12 174%
Prospect Med Group [893] $12 174%
Radys Cpmg [803] $20 - $28 290%
Mc Alignment [917] $41 - $55 595%
Mc Blue Shield Promise Health Plan [914] $41 - $55 595%
Mc Blue Shield [902] $41 - $55 595%
Mc Health Net [904] $41 - $55 595%
Mc Scan [905] $41 - $55 595%
Mc United [906] $41 - $55 595%
Bc [814] $56 - $76 813%
Imperial County Phys Med Group [855] $56 - $118 813%
Integrated Health Partners [894] $56 - $76 813%
Perlman Med Group [899] $56 - $76 813%
Sharp Comm Med Grp [812] $56 - $157 813%
Sharp Rees Stealy Med Grp [811] $56 - $157 813%
Ucsd [807] $56 - $157 813%
Centivo [581] $59 - $79 856%
Blue Shield [230] $84 - $124 1219%
Hn [815] $86 - $116 1248%
Bs [816] $87 - $123 1263%
Uh [819] $89 - $121 1292%
Kaiser Northern Ca Region Hmo/Ppo [384] $96 - $130 1393%
Kaiser [380] $96 - $130 1393%
Kaiser [383] $96 - $130 1393%
Rady Children'S Hospital [825] $105 - $142 1524%
Palomar Health [892] $116 - $157 1684%
Veba Med Grp [813] $116 - $157 1684%
Multi Plan Network [470] $181 - $245 2627%
First Health Network [330] $192 - $259 2787%
Pnoa [615] $192 - $259 2787%
Choice Care Network [270] $204 - $276 2961%
Healthsmart [350] $204 - $276 2961%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4077 5Th Ave, San Diego, CA 92103
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals