CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Scripps Memorial Hospital - Encinitas

Billing Code: 871 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$21,283

about 1.5× the $14,117 Medicare rate · typically $16,970–$22,505

modeled estimate · not a bill or quote

What this hospital charges insurers

$19,003

Below the fair price — a good deal

about $2,280 under the fair price · 1.3× Medicare

Medicare pays $14,117 Fair price $21,283 This hospital $19,003 Cash price $17,036 Hospital's list price $68,145

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 $12,833 Priciest $19,003

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

A fair price for a Sepsis treatment (inpatient stay) is about $21,283 (about 1.5× the $14,117 Medicare rate). Scripps Memorial Hospital - Encinitas charges insurers about $19,003, or about $17,036 in cash — below the fair price — a good deal. 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	$18,932 - $65,004	134%
Blue Cross Blue Shieldmajor	$16,278 - $53,320	115%
Aetnamajor	$18,932 - $71,886	134%
Cignamajor	$18,932 - $62,319	134%
Humanamajor	$18,932	134%
Kaiser Permanentemajor	$18,932	134%
Health Net	$18,932 - $44,575	134%
HealthPartners	$18,932 - $27,795	134%
+ 35 smaller / regional plans	$18,932 - $62,319

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 17,036), 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: 871.

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 871.
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: Sepsis treatment (inpatient stay) at other CA hospitals

College Medical Center · Long Beach $12,833
Salinas Valley Memorial Hospital · Salinas $17,413
Adventist Health Tehachapi Valley · Tehachapi $18,297
Good Samaritan Hospital, LP · Bakersfield $18,325
San Dimas Community Hospital · San Dimas $18,439
French Hospital Medical Center · San Luis Obispo $18,440
Casa Colina Hospital · Pomona $18,457
Oak Valley Hospital District · Oakdale $18,577

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