CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Scripps Memorial Hospital - Encinitas

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $396
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 3.71x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Scripps Memorial Hospital - Encinitas is $396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.71x the Medicare baseline. Located in 354 Santa Fe Drive, Encinitas, CA.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$396

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $407 (381%)
Insurance Median: $396 (371%)
Cash: $407 (381% of Medicare)
Ins. Median: $396 (371% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 371% of the Medicare baseline (a markup of 271%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $70 - $902 66%
UnitedHealthcare $70 - $627 66%
Radys Cpmg [803] $117 - $143 110%
Astiva Mcr Adv [464] $134 125%
Bc Mcr Adv [830] $134 125%
Blue Cross Blue Shield $134 - $473 125%
Bs Mcr Adv [829] $134 125%
Central Health Mcr Adv [441] $134 125%
Cigna $134 - $707 125%
Clever Care Mcr Adv [465] $134 125%
D-Snp Mcr Adv [889] $134 125%
Dsnp/Csnp - Generic [458] $134 125%
Family Health Centers Pace Mcr Adv Hmo [556] $134 125%
Family Health Centers Pace Medi-Cal [555] $134 125%
Gary And Mary West Pace Medi-Cal Hmo [557] $134 125%
Gpmg/Altura - Mcr Adv [888] $134 125%
Hn Mcr Adv [832] $134 125%
Humana $134 125%
Integrated Health Partners - Mcr Adv [895] $134 125%
Kaiser Northern Ca Region Mcr Adv [386] $134 125%
La Care Mcr Adv Hmo [612] $134 125%
Medicare (plans) $134 125%
Mpmg Mcr Adv [836] $134 125%
Mpmg [800] $134 125%
Ocn Mcr Adv [890] $134 125%
San Diego Pace Medi-Cal [553] $134 125%
Scan Mcr Adv [835] $134 125%
Scan [500] $134 125%
Scan [818] $134 125%
Sharp Comm Med Grp Mcr Adv [840] $134 125%
Sharp Health Plan Mcr Adv [531] $134 125%
Sharp Health Plan Mcr Adv [897] $134 125%
Sharp Rees Stealy Med Grp Mcr Adv [841] $134 125%
St Paul'S Pace Medi-Cal [551] $134 125%
Ucsd Mcr Adv [873] $134 125%
Uh Mcr Adv [831] $134 125%
Uh Palomar Health Mcr Adv [885] $134 125%
Alignment Health Plan [443] $138 129%
Health Net [340] $214 - $602 200%
Prime Healthcare [614] $229 214%
Prospect Med Group [893] $235 220%
Mc Alignment [917] $249 - $304 233%
Mc Blue Shield Promise Health Plan [914] $249 - $304 233%
Mc Blue Shield [902] $249 - $304 233%
Mc Health Net [904] $249 - $304 233%
Mc Scan [905] $249 - $304 233%
Mc United [906] $249 - $304 233%
Bc [814] $323 - $396 302%
Imperial County Phys Med Group [855] $323 - $611 302%
Integrated Health Partners [894] $323 - $396 302%
Perlman Med Group [899] $323 - $396 302%
Sharp Comm Med Grp [812] $323 - $813 302%
Sharp Rees Stealy Med Grp [811] $323 - $813 302%
Ucsd [807] $323 - $813 302%
Centivo [581] $337 - $412 316%
Blue Shield [230] $481 - $641 450%
Hn [815] $492 - $602 461%
Bs [816] $499 - $636 467%
Uh [819] $512 - $627 479%
Rady Children'S Hospital [825] $600 - $734 562%
Palomar Health [892] $664 - $813 622%
Veba Med Grp [813] $664 - $813 622%
Kaiser Northern Ca Region Hmo/Ppo [384] $834 - $1,021 781%
Kaiser [380] $834 - $1,021 781%
Kaiser [383] $834 - $1,021 781%
Multi Plan Network [470] $1,039 - $1,271 973%
First Health Network [330] $1,097 - $1,343 1027%
Pnoa [615] $1,097 - $1,343 1027%
Choice Care Network [270] $1,171 - $1,432 1096%
Healthsmart [350] $1,171 - $1,432 1096%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 354 Santa Fe Drive, Encinitas, CA 92024
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals