CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Scripps Memorial Hospital - Encinitas

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$32,924

about 1.4× the $23,504 Medicare rate · typically $19,827–$37,325

modeled estimate · not a bill or quote

What this hospital charges insurers

$31,339

About the fair price

about $1,585 under the fair price · 1.3× Medicare

Medicare pays $23,504 Fair price $32,924 This hospital $31,339 Cash price $111,502 Hospital's list price $446,008

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 $31,339

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Spinal fusion, single level (inpatient stay) is about $32,924 (about 1.4× the $23,504 Medicare rate). Scripps Memorial Hospital - Encinitas charges insurers about $31,339, or about $111,502 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	$31,339 - $36,532	133%
Blue Cross Blue Shieldmajor	$31,339	133%
Aetnamajor	$31,339 - $44,667	133%
Cignamajor	$31,339 - $103,638	133%
Humanamajor	$31,339	133%
Kaiser Permanentemajor	$31,339	133%
Health Net	$31,339 - $31,575	133%
HealthPartners	$31,339	133%
+ 32 smaller / regional plans	$31,339 - $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 111,502), 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 Memorial Hospital - Encinitas 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 Memorial Hospital - Encinitas

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.