CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Scripps Memorial Hospital La Jolla

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $7,711
  • Cash Discount Price: $9,543
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Scripps Memorial Hospital La Jolla is $7,711. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,543. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.36x the Medicare baseline. Located in 9888 Genesee Avenue, La Jolla, CA.
Cash / Self-Pay
$9,543

Average discount available for prompt cash payment at this facility.

Insurance Median
$7,711

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Cash / Self-Pay: $9,543 (168%)
Insurance Median: $7,711 (136%)
Cash: $9,543 (168% of Medicare)
Ins. Median: $7,711 (136% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 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.

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
Blue Cross Blue Shield $6,533 - $21,399 115%
Aetna $7,711 - $28,851 136%
Astiva Mcr Adv [464] $7,711 136%
Bc Mcr Adv [830] $7,711 136%
Bs Mcr Adv [829] $7,711 136%
Central Health Mcr Adv [441] $7,711 136%
Cigna $7,711 - $25,011 136%
Clever Care Mcr Adv [465] $7,711 136%
D-Snp Mcr Adv [889] $7,711 136%
Dsnp/Csnp - Generic [458] $7,711 136%
Family Health Centers Pace Mcr Adv Hmo [556] $7,711 136%
Family Health Centers Pace Medi-Cal [555] $7,711 136%
Gary And Mary West Pace Medi-Cal Hmo [557] $7,711 136%
Gpmg/Altura - Mcr Adv [888] $7,711 136%
Health Net [340] $7,711 - $17,889 136%
Hn Mcr Adv [832] $7,711 136%
Humana $7,711 136%
Integrated Health Partners - Mcr Adv [895] $7,711 136%
La Care Mcr Adv Hmo [612] $7,711 136%
Mc Alignment [917] $7,711 136%
Mc Blue Shield Promise Health Plan [914] $7,711 136%
Mc Blue Shield [902] $7,711 136%
Mc Health Net [904] $7,711 136%
Mc Scan [905] $7,711 136%
Mc United [906] $7,711 136%
Medicare (plans) $7,711 136%
San Diego Pace Medi-Cal [553] $7,711 136%
Scan Mcr Adv [835] $7,711 136%
Scan [500] $7,711 136%
Scan [818] $7,711 136%
Sharp Comm Med Grp Mcr Adv [840] $7,711 136%
Sharp Health Plan Mcr Adv [531] $7,711 136%
Sharp Health Plan Mcr Adv [897] $7,711 136%
Sharp Rees Stealy Med Grp Mcr Adv [841] $7,711 136%
St Paul'S Pace Medi-Cal [551] $7,711 136%
Ucsd Mcr Adv [873] $7,711 136%
Uh Mcr Adv [831] $7,711 136%
Uh Palomar Health Mcr Adv [885] $7,711 136%
UnitedHealthcare $7,711 - $26,089 136%
Alignment Health Plan [443] $7,942 140%
Mpmg Mcr Adv [836] $9,547 168%
Mpmg [800] $9,547 168%
Ocn Mcr Adv [890] $9,547 168%
Centivo [581] $10,914 192%
Bc [814] $11,155 197%
Imperial County Phys Med Group [855] $11,155 197%
Integrated Health Partners [894] $11,155 197%
Perlman Med Group [899] $11,155 197%
Sharp Comm Med Grp [812] $11,155 - $25,011 197%
Sharp Rees Stealy Med Grp [811] $11,155 - $25,011 197%
Ucsd [807] $11,155 - $25,011 197%
Prime Healthcare [614] $13,108 231%
Prospect Med Group [893] $13,493 238%
Uh [819] $14,306 252%
Hn [815] $17,889 315%
Palomar Health [892] $20,146 355%
Veba Med Grp [813] $20,146 355%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9888 Genesee Avenue, La Jolla, CA 92037
  • CMS Rating: ★★★★★
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals