CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Scripps Memorial Hospital - Encinitas

Billing Code: 322 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$19,100

about 1.5× the $12,807 Medicare rate · typically $15,718–$20,744

modeled estimate · not a bill or quote

What this hospital charges insurers

$17,267

About the fair price

about $1,833 under the fair price · 1.3× Medicare

Medicare pays $12,807 Fair price $19,100 This hospital $17,267 Cash price $37,096 Hospital's list price $148,385

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 $11,647 Priciest $17,267

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

A fair price for a Heart stent placement (inpatient stay) is about $19,100 (about 1.5× the $12,807 Medicare rate). Scripps Memorial Hospital - Encinitas charges insurers about $17,267, or about $37,096 in cash — about the fair price. Located in Encinitas, 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	$17,203 - $27,956	134%
Blue Cross Blue Shieldmajor	$14,774 - $48,393	115%
Aetnamajor	$17,203 - $65,243	134%
Cignamajor	$17,203 - $33,361	134%
Humanamajor	$17,203	134%
Kaiser Permanentemajor	$17,203	134%
Health Net	$17,203 - $40,456	134%
HealthPartners	$17,203 - $25,227	134%
+ 35 smaller / regional plans	$17,203 - $45,558

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 37,096), 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: 322.

Insurance Before you use insurance

Call your insurance company to confirm Scripps Memorial Hospital - Encinitas is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 322.
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 Memorial Hospital - Encinitas

Compare: Heart stent placement (inpatient stay) at other CA hospitals

College Medical Center · Long Beach $11,647
Salinas Valley Memorial Hospital · Salinas $15,804
Good Samaritan Hospital, LP · Bakersfield $16,639
San Dimas Community Hospital · San Dimas $16,758
Saint John's Health Center · Santa Monica $17,013
French Hospital Medical Center · San Luis Obispo $17,018
Adventist Health and Rideout · Marysville $17,022
Garden Grove Hospital & Medical Center · Garden Grove $17,064

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