How many shoppable procedure prices are published for Rady Children's Hospital - San Diego?

Rady Children's Hospital - San Diego in San Diego, CA currently has 120 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Rady Children's Hospital - San Diego's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Rady Children's Hospital - San Diego's median negotiated commercial rate is 2.7× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Other 401 Beds · urban Updated: 2026-04-01

Rady Children's Hospital - San Diego

3020 Childrens Way, San Diego, CA 92123 · 120 Priced Procedures

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

2.73×vs. Fair Market Price

Typical commercial prices here are +173% above the fair benchmark (2.73×) even after accounting for local nurse/doctor wages and patient complexity.

67/100 · Caution

67/100Self-Pay Cash Beats Insurance 11% of the Time

File Completeness85

Price Logic54

Peer Alignment61

Clean Billing38

Real Cash Discount100

High-Markup · Check Safety

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintUpper-Quartile Spread · +65% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Rady Children's Hospital - San Diego prices routine shoppable procedures at 4.8× Medicare (median 2.77× Fair BaseRate) while upper-quartile commercial rates jump +65% to 4.58× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#233 of 240 in CA · 96th State Percentile#3,300 of 3,385 in U.S. · 97th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.50× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 11% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (29.1% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (2.73× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Commercial insurance median sits at 2.77× Fair BaseRate (4.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 4.58×) jump +65% above the median procedure ratio (Q50 2.77×)
Unnegotiated chargemaster list prices average 14.7× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

4.8× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.33× Divergence

1.6× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+65% Upper Tail

Q25 1.50× · Q50 2.77× · Q75 4.58×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

4.8× MedicareWatchout

Outpatient Surgery & ORBack-Door Captive

0.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.0× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.8× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.9× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.7× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

11% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Rady Children's Hospital - San Diego

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 120 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$17,854	$6,109	unverified
Total knee replacement CPT Code: `27447`	—	$17,366	$13,523	1.3×
Trauma team activation HCPCS Code: `G0390`	$14,806	$14,806	$1,453	10.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$11,636	$2,540	unverified
Total hip replacement CPT Code: `27130`	—	$11,459	$13,413	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$10,375	$3,372	3.1×
Inguinal hernia repair CPT Code: `49505`	—	$10,375	$3,629	2.9×
C-section delivery (full package) CPT Code: `59510`	—	$9,918	$2,975	3.3×
Bunion correction surgery CPT Code: `28296`	—	$9,669	$3,446	2.8×
Breast lump removal CPT Code: `19120`	—	$9,449	$3,875	2.4×
Vaginal delivery (full package) CPT Code: `59400`	—	$9,420	$2,680	3.5×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$6,863	$981	unverified
Colonoscopy with biopsy CPT Code: `45380`	—	$6,863	$1,256	unverified
MRI, brain (with and without contrast) CPT Code: `70553`	$6,400	$6,400	$511	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$5,191	$5,191	$338	15.4×
MRI, brain (no contrast) CPT Code: `70551`	$3,645	$2,557	$343	7.5×
MRI, knee or other leg joint CPT Code: `73721`	$4,590	$2,548	$369	6.9×
Blood transfusion CPT Code: `36430`	$1,661	$1,879	$498	3.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,956	$1,871	$583	3.2×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,430	$1,620	$258	6.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$5,414	$1,552	$448	3.5×
Sleep study (overnight, in lab) CPT Code: `95810`	$5,423	$1,553	$1,021	1.5×
Upper endoscopy with biopsy CPT Code: `43239`	$1,414	$1,414	$987	unverified
CT scan, pelvis CPT Code: `72192`	$2,982	$1,354	$163	8.3×
CT scan, chest (no contrast) CPT Code: `71250`	$2,914	$1,354	$167	8.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$3,483	$1,354	$168	8.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$3,351	$1,354	$169	8.0×
CT scan, head (with contrast) CPT Code: `70460`	$3,167	$1,298	$242	5.4×
CT scan, head (no contrast) CPT Code: `70450`	$2,330	$1,082	$160	6.8×
CT scan, sinuses CPT Code: `70486`	$2,576	$1,085	$166	6.5×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,091	$1,028	$272	3.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$5,237	$813	$303	2.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	—	$760	$148	5.1×
Screening mammogram (both breasts) CPT Code: `77067`	—	$628	$123	5.1×
New patient office visit (30-44 min) CPT Code: `99203`	$515	$515	$110	4.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$441	$441	$87	5.1×
Office visit, established patient (30-39 min) CPT Code: `99214`	$455	$455	$123	3.7×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,056	$456	$134	3.4×
Hepatitis B immune globulin HCPCS Code: `90371`	$439	$439	$151	2.9×
Ultrasound, pelvis CPT Code: `76856`	$555	$354	$130	2.7×
Ultrasound, abdomen (limited) CPT Code: `76705`	$691	$329	$126	2.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$596	$329	$132	2.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$307	$307	$185	1.7×
Rabies immune globulin HCPCS Code: `90375`	—	$298	$322	0.9×
X-ray, hip CPT Code: `73502`	$687	$269	$93	2.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$259	$259	$181	1.4×
Neurobehavioral status check CPT Code: `96116`	$279	$279	$231	1.2×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$253	$35	7.2×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$294	$225	$25	9.0×
Speech therapy (group session) CPT Code: `92508`	$206	$206	$27	7.6×
Hospital observation (per hour) HCPCS Code: `G0378`	$215	$215	$86	2.5×
Care planning with family CPT Code: `90887`	$225	$225	$107	2.1×
X-ray, lower back CPT Code: `72110`	$812	$211	$112	1.9×
Family therapy session CPT Code: `90847`	$216	$216	$173	1.2×
X-ray, chest (two views) CPT Code: `71046`	$344	$180	$93	1.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$203	$203	$166	1.2×
Psychological testing by technician CPT Code: `96138`	$225	$225	$395	unverified
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$173	$173	$38	4.6×
Orthotic fitting and training CPT Code: `97760`	$181	$181	$51	3.5×
Speech therapy (language evaluation) CPT Code: `92507`	$173	$173	$86	2.0×
Physical therapy (gait training) CPT Code: `97116`	$121	$121	$33	3.7×
Prosthetic fitting and training CPT Code: `97761`	$129	$129	$45	2.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$224	$130	$64	2.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$565	$139	$93	1.5×
X-ray, shoulder CPT Code: `73030`	$606	$132	$92	1.4×
Group therapy session CPT Code: `90853`	$135	$135	$100	1.4×
Psychological testing evaluation CPT Code: `96136`	$152	$152	$128	unverified
Physical therapy (therapeutic exercise) CPT Code: `97110`	$99	$99	$35	2.8×
Mental health services (therapy) HCPCS Code: `H0032`	$75	$100	$65	1.5×
X-ray, foot CPT Code: `73630`	$489	$123	$92	1.3×
X-ray, hand CPT Code: `73130`	$468	$123	$93	1.3×
X-ray, ankle CPT Code: `73610`	$504	$123	$93	1.3×
X-ray, pelvis CPT Code: `72170`	$453	$121	$110	1.1×
X-ray, chest (single view) CPT Code: `71045`	$292	$98	$92	1.1×
Mental health services (assessment) HCPCS Code: `H0031`	—	$120	$140	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$165	$119	$201	0.6×
Physical therapy (manual therapy) CPT Code: `97140`	$92	$92	$34	2.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$95	$95	$40	2.4×
Behavioral health day program HCPCS Code: `H2012`	—	$100	$100	1.0×
Typhoid vaccine HCPCS Code: `90675`	$1,671	$594	$347	1.7×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$295	$295	$11	26.8×
Culture, blood CPT Code: `87040`	$257	$257	$11	23.4×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$812	$263	$203	1.3×
Blood test, basic metabolic panel CPT Code: `80048`	$206	$206	$9	22.9×
Blood test, liver function panel CPT Code: `80076`	$187	$187	$9	20.8×
Blood test, ferritin (iron stores) CPT Code: `82728`	$146	$146	$14	10.4×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$451	$169	$111	1.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$254	$168	$56	unverified
Blood test, complete blood count (CBC) CPT Code: `85025`	$106	$106	$8	13.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$130	$130	$14	9.3×
Hepatitis B vaccine HCPCS Code: `90744`	$111	$117	$37	3.2×
Blood test, lipase CPT Code: `83690`	$75	$75	$7	10.7×
Culture, bacterial CPT Code: `87070`	$86	$86	$9	9.6×
Blood test, hemoglobin CPT Code: `85018`	$56	$56	$3	18.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$77	$77	$10	7.7×
Blood test, vitamin B12 CPT Code: `82607`	$99	$99	$16	6.2×
Blood test, vitamin D CPT Code: `82306`	$107	$107	$31	3.5×
Blood test, thyroid (TSH) CPT Code: `84443`	$78	$78	$18	4.3×
Occupational therapy (self-care training) CPT Code: `97535`	$79	$79	$38	2.1×
Physical therapy (functional capacity test) CPT Code: `97750`	$77	$77	$38	2.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$80	$79	$39	2.0×
Blood antibody screen CPT Code: `86850`	$82	$87	$46	1.9×
Drug screening test HCPCS Code: `G0480`	$98	$98	$116	0.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$48	$48	$3	16.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$47	$47	$4	11.8×
Blood test, potassium CPT Code: `84132`	$50	$50	$5	10.0×
Blood test, calcium CPT Code: `82310`	$47	$47	$5	9.4×
Pneumococcal vaccine HCPCS Code: `90732`	$582	$71	$140	0.5×
Hepatitis C antibody test CPT Code: `86803`	$94	$94	$15	unverified
Blood test, sodium CPT Code: `84295`	$42	$42	$5	8.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$39	$39	$5	7.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$30	$30	$4	7.5×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$37	$37	$5	7.4×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$59	$25	2.4×
Colorectal cancer screening HCPCS Code: `G0010`	$42	$42	$49	0.9×
Review of medical records for care CPT Code: `90889`	$56	$56	$114	0.5×
Blood test, amylase CPT Code: `82150`	$49	$49	$7	unverified
Blood test, magnesium CPT Code: `83735`	$62	$62	$7	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$28	$28	$6	4.7×
Blood test, PSA (prostate screen) CPT Code: `84153`	$6	$6	$19	unverified

Showing top 25 high-impact procedures of 120 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 29.1%

Audit a Bill or Quote at Rady Children's Hospital - San Diego (Zero PHI Required)

CMS CCN: 053303

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash Request Quote

Insurer Median $17,854

1. Amount on Your Bill or Quote ($) Pre-filled with Rady Children's Hospital - San Diego’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $12,486 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $12,486

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (29.1% of gross = $12,486).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Rady Children's Hospital - San Diego's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$36,741 Above Fair BaseRate

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

Your bill ($42,850) is $36,741 above the denoised Fair BaseRate ($6,109) and 6.9× the $6,176 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 951691313

Filing Period: 199707

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (29.1% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Rady Children's Hospital - San Diego. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-11·administrative_or_closure
Closure Notice
Recorded
2025-04-16·warning_notice
Warning Notice
Recorded
2023-08-17·administrative_or_closure
Closure Notice
Recorded
2023-04-14·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Above-Benchmark Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Rady Children's Hospital - San Diego.

Price Index: 1.46× regional baseline

Quality: 54/100 CMS composite

Median Household Income$102,285U.S. Census ACS

Local Uninsured Share6.8%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 67/100 · Caution CMS CCN 053303 EIN 951691313

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 053303) ↗ Verify IRS Form 990 (EIN 951691313) ↗ CMS HCRIS Cost Reports ↗

Published MRF File95-1691313_rady-childrens-hospital-san-diego_standardcharges.csv

Publication / Vintage2026-04-01 · 31.57 MB

Validated Rate Rows224 (CMS v3.0.0)

File Integrity Digest69b09a53d778d6c235ec…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy