CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Scripps Mercy Hospital

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$31,936

about 1.4× the $23,504 Medicare rate · typically $19,005–$38,292

modeled estimate · not a bill or quote

What this hospital charges insurers

$36,532

About the fair price

about $4,596 over the fair price · 1.6× Medicare

Medicare pays $23,504 Fair price $31,936 This hospital $36,532 Cash price $46,155 Hospital's list price $184,621

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $21,342 Priciest $36,532

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $31,936 (about 1.4× the $23,504 Medicare rate). Scripps Mercy Hospital charges insurers about $36,532, or about $46,155 in cash — about the fair price. Located in San Diego, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$34,033 - $108,102	145%
Blue Cross Blue Shieldmajor	$27,071 - $88,671	115%
Aetnamajor	$34,033 - $44,667	145%
Cignamajor	$34,033 - $103,638	145%
Humanamajor	$34,033	145%
Kaiser Permanentemajor	$34,033	145%
Health Net	$34,033 - $74,128	145%
HealthPartners	$34,033 - $46,224	145%
+ 36 smaller / regional plans	$34,033 - $103,638

Government programs also on file: Medicare, Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 46,155), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm Scripps Mercy Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Scripps Mercy Hospital

Compare: Spinal fusion, single level (inpatient stay) at other CA hospitals

College Medical Center · Long Beach $21,342
French Hospital Medical Center · San Luis Obispo $28,890
Salinas Valley Memorial Hospital · Salinas $28,958
Mercy Hospital of Folsom · Folsom $30,162
Good Samaritan Hospital, LP · Bakersfield $30,419
Sierra Nevada Memorial Hospital · Grass Valley $30,438
Mercy Medical Center Redding · Redding $30,746
Mercy Hospital · Bakersfield $30,802

Insurance negotiated median for the same procedure, sorted lowest first.