CMS Price Transparency Data

Blood test, potassium

Facility: Scripps Mercy Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $11
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Scripps Mercy Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 2.31x the Medicare baseline. Located in 4077 5Th Ave, San Diego, CA.
Cash / Self-Pay
$12

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $12 (252%)
Insurance Median: $11 (231%)
Cash: $12 (252% of Medicare)
Ins. Median: $11 (231% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 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 231% of the Medicare baseline (a markup of 131%). 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
Radys Cpmg [803] $3 - $4 63%
Aetna $5 - $25 105%
Alignment Health Plan [443] $5 105%
Astiva Mcr Adv [464] $5 105%
Bc Mcr Adv [830] $5 105%
Blue Cross Blue Shield $5 - $13 105%
Bs Mcr Adv [829] $5 105%
Central Health Mcr Adv [441] $5 105%
Cigna $5 - $17 105%
Clever Care Mcr Adv [465] $5 105%
D-Snp Mcr Adv [889] $5 105%
Dsnp/Csnp - Generic [458] $5 105%
Family Health Centers Pace Mcr Adv Hmo [556] $5 105%
Family Health Centers Pace Medi-Cal [555] $5 105%
Gary And Mary West Pace Medi-Cal Hmo [557] $5 105%
Gpmg/Altura - Mcr Adv [888] $5 105%
Hn Mcr Adv [832] $5 105%
Humana $5 105%
Integrated Health Partners - Mcr Adv [895] $5 105%
Kaiser Northern Ca Region Mcr Adv [386] $5 105%
La Care Mcr Adv Hmo [612] $5 105%
Medicare (plans) $5 105%
Mpmg Mcr Adv [836] $5 105%
Mpmg [800] $5 105%
Ocn Mcr Adv [890] $5 105%
San Diego Pace Medi-Cal [553] $5 105%
Scan Mcr Adv [835] $5 105%
Scan [500] $5 105%
Scan [818] $5 105%
Sharp Comm Med Grp Mcr Adv [840] $5 105%
Sharp Health Plan Mcr Adv [531] $5 105%
Sharp Health Plan Mcr Adv [897] $5 105%
Sharp Rees Stealy Med Grp Mcr Adv [841] $5 105%
St Paul'S Pace Medi-Cal [551] $5 105%
Ucsd Mcr Adv [873] $5 105%
Uh Mcr Adv [831] $5 105%
Uh Palomar Health Mcr Adv [885] $5 105%
UnitedHealthcare $5 - $17 105%
Mc Alignment [917] $6 - $8 126%
Mc Blue Shield Promise Health Plan [914] $6 - $8 126%
Mc Blue Shield [902] $6 - $8 126%
Mc Health Net [904] $6 - $8 126%
Mc Scan [905] $6 - $8 126%
Mc United [906] $6 - $8 126%
Health Net [340] $8 - $17 168%
Prime Healthcare [614] $8 168%
Prospect Med Group [893] $8 168%
Bc [814] $10 - $11 210%
Centivo [581] $10 - $11 210%
Imperial County Phys Med Group [855] $10 - $17 210%
Integrated Health Partners [894] $10 - $11 210%
Perlman Med Group [899] $10 - $11 210%
Sharp Comm Med Grp [812] $10 - $22 210%
Sharp Rees Stealy Med Grp [811] $10 - $22 210%
Ucsd [807] $10 - $22 210%
Blue Shield [230] $14 - $18 294%
Bs [816] $15 - $18 315%
Hn [815] $15 - $17 315%
Uh [819] $15 - $17 315%
Kaiser Northern Ca Region Hmo/Ppo [384] $16 - $19 336%
Kaiser [380] $16 - $19 336%
Kaiser [383] $16 - $19 336%
Rady Children'S Hospital [825] $18 - $20 378%
Palomar Health [892] $20 - $22 420%
Veba Med Grp [813] $20 - $22 420%
Multi Plan Network [470] $31 - $35 651%
First Health Network [330] $32 - $37 672%
Pnoa [615] $32 - $37 672%
Choice Care Network [270] $35 - $40 735%
Healthsmart [350] $35 - $40 735%

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