Does Scripps Memorial Hospital - Encinitas have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Scripps Memorial Hospital - Encinitas. In a medical emergency, call 911.

Where is Scripps Memorial Hospital - Encinitas?

354 Santa Fe Drive, Encinitas, CA 92024, in San Diego County, California.

What is the phone number of Scripps Memorial Hospital - Encinitas?

(760) 753-6501, as listed by Medicare (CMS).

What is the Medicare star rating of Scripps Memorial Hospital - Encinitas?

4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Does Medicare reduce its payments to Scripps Memorial Hospital - Encinitas for hospital-acquired conditions?

No. For fiscal year 2026, CMS lists no Medicare payment reduction for Scripps Memorial Hospital - Encinitas under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.3285; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Scripps Memorial Hospital - Encinitas

Quick answers

Does Scripps Memorial Hospital - Encinitas have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Scripps Memorial Hospital - Encinitas. In a medical emergency, call 911.
Where is Scripps Memorial Hospital - Encinitas?: 354 Santa Fe Drive, Encinitas, CA 92024, in San Diego County, California.
What is the phone number of Scripps Memorial Hospital - Encinitas?: (760) 753-6501, as listed by Medicare (CMS).
What is the Medicare star rating of Scripps Memorial Hospital - Encinitas?: 4 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).
Does Medicare reduce its payments to Scripps Memorial Hospital - Encinitas for hospital-acquired conditions?: No. For fiscal year 2026, CMS lists no Medicare payment reduction for Scripps Memorial Hospital - Encinitas under the Hospital-Acquired Condition Reduction Program (Total HAC Score: -0.3285; a lower score is better). It is an adjustment to what Medicare pays the hospital, not a charge to patients (CMS data released January 26, 2026).

Specialties and care areas^[4][5]

Conditions treated^[5][7][11]

Alzheimer's and related dementias
Epilepsy and seizures
Diabetes
Chronic kidney disease
Hypertension
Inflammatory bowel diseases
Cerebrovascular disease
Peripheral vascular diseases
Stroke
Heart attack
Heart failure
Heart arrhythmia
Chronic obstructive pulmonary disease (COPD)
Kidney failure
Pneumonia
Hip fracture
Leukemia
Lymphoma
Myeloma

Treatments^[4][5]

Stroke rehabilitation
Minimally invasive robotic surgery
Occupational therapy
Balance and vestibular therapy
Angioplasty
Brain injury day treatment

Procedures^[5]

Hip replacement surgery
Knee replacement surgery
Cardiac catheterization
Robotic hysterectomy
Robotic prostatectomy
Colon and rectal surgery
Head and neck surgery
Outpatient surgery
MRI
CT

Programs and centers^{[4][6][7][9][12]}

Brain injury day treatment program
Baby Friendly birthing pavilion
Level II NICU
24-hour emergency room
Family Birth Pavilion (labor and delivery)
Level II neonatal intensive care unit
Ambulatory surgery center
Rooftop helistop

Emergency care (hospital website)^{[4][6][7][11]}

Emergency room	Yes
Open 24/7	Yes
Stroke designation	Primary Stroke Center (The Joint Commission)

Visiting and practical information

Visiting	General visiting hours 8 a.m.-8:30 p.m., adjustable to patient needs^[4]
Parking	Parking is free^[4]
Interpreters and languages	Links to a Language Services (medical interpreters) page^[4]
Patient portal	MyScripps

Recognition^[4][10][11]

Accredited stroke care (as worded on page)
Baby Friendly birthing pavilion
Primary Stroke Center (The Joint Commission)

Doctors and clinicians (1,043)

1,043 doctors and other clinicians list Scripps Memorial Hospital - Encinitas as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 1,019 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Kaiser Foundation Hospital - San Marcos9.3 mi · San Marcos, CA · Acute Care Hospital
Scripps Memorial Hospital La Jolla11 mi · La Jolla, CA · Acute Care Hospital
Tri-City Medical Center11 mi · Oceanside, CA · Acute Care Hospital
VA San Diego Healthcare System12 mi · San Diego, CA · Federal/VA Acute Care Hospital
Palomar Medical Center Poway13 mi · Poway, CA · Acute Care Hospital

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Encinitas

Scripps Green Hospital9.9 mi · La Jolla, CA · Acute Care Hospital
Palomar Rehabilitation Institute11 mi · Escondido, CA · Inpatient Rehabilitation Hospital

Hospitals in San Diego County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Aviara Healthcare Center0.4 mi · Encinitas, CA · 4 of 5 stars
Encinitas Post-Acute0.9 mi · Encinitas, CA · 4 of 5 stars
The Dorothy & Joseph Goldberg Healthcare Center1.1 mi · Encinitas, CA · 5 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice by the Sea3.1 mi · Solana Beach, CA
Ardent Hospice7.5 mi · Carlsbad, CA
Hospice of the North Coast7.5 mi · Carlsbad, CA · 4 of 5 stars

All hospice providers in the state →

Home health agencies

At Home Nursing Care Inc2.1 mi · Encinitas, CA
Trio Home Health Care of San Diego Inc2.1 mi · Encinitas, CA · 5 of 5 stars
All Concierge Homehealth Inc4.9 mi · Carlsbad, CA

All home health agencies in the state →

Dialysis facilities

DaVita Encinitas Dialysis2.1 mi · Encinitas, CA · 4 of 5 stars
Fresenius Medical Care of La Jolla7.7 mi · San Diego, CA · 2 of 5 stars
Fresenius Medical Care Buena Creek9.2 mi · Vista, CA · 4 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Scripps Encinitas Surgery Center2.1 mi · Encinitas, CA
The Endoscopy Center2.1 mi · Encinitas, CA
UCSD Center for Surgery of Encinitas2.1 mi · Encinitas, CA

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

TrueCare0.5 mi · Encinitas, CA · Community health center
TrueCare Rancho Sante Fe QuickCare8.9 mi · San Marcos, CA · Community health center
TrueCare9.0 mi · San Marcos, CA · Community health center

Clinics and urgent care

Access Medical Center2.1 mi · Encinitas, CA · Urgent care center
MDS by the Sea Inc2.1 mi · Encinitas, CA · Urgent care center
Monica Perlman MD Inc.4.7 mi · Carlsbad, CA · Urgent care center

Pharmacies

Longs Drug Stores California LLC2.1 mi · Encinitas, CA · Pharmacy
North County Health Project Inc2.1 mi · Encinitas, CA · Pharmacy
Regents of the University of California2.1 mi · Encinitas, CA · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state license list, by straight-line distance.

Belmont Village Cardiff1.1 mi · Cardiff By Th, CA
Compassionate Elder Care2.1 mi · Encinitas, CA
Leichtag Family Assisted Living Residen2.1 mi · Encinitas, CA
Ranchview Senior Assisted Living2.1 mi · Encinitas, CA

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Scripps Memorial Hospital - Encinitas reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	4 of 5 stars
Overall rating of the hospital	4 of 5 stars
Would recommend the hospital	5 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Patients got help quickly from staff	3 of 5 stars
Staff explained medicines	4 of 5 stars
Information about recovery at home	4 of 5 stars
Room and bathroom kept clean	4 of 5 stars
Restfulness of Environment	2 of 5 stars
Care Coordination	4 of 5 stars
Symptoms After Stay	4 of 5 stars
Rated the hospital 9 or 10 out of 10	77%National average: 72%
Would definitely recommend the hospital	81%National average: 71%
Nurses “always” communicated well	82%National average: 80%
Doctors “always” communicated well	82%National average: 80%
“Always” got help as soon as they wanted	62%National average: 64%
Staff “always” explained medicines before giving them	65%National average: 62%
Were given information about recovery at home	90%National average: 86%
Room and bathroom “always” clean	77%National average: 73%
Completed surveys	2,615Response rate: 28%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	0.64No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.611No different from the national benchmark
Surgical site infections after colon surgery	1.414No different from the national benchmark
MRSA bloodstream infections	0.675No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.442Better than the national benchmark
Not reported to Medicare	Surgical site infections after abdominal hysterectomy

Source: Healthcare Associated Infections - Hospital — CMS, released October 19, 2026; data from January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	10.5%
Deaths within 30 days: heart failure patients	7.6%
Deaths within 30 days: pneumonia patients	10.7%
Deaths within 30 days: COPD patients	8.2%
Deaths within 30 days: stroke patients	10%
Serious complications (patient safety indicator PSI-90)	0.82No different from the national rate
Complications after hip or knee replacement	5.6%
Not reported to Medicare	Deaths within 30 days: coronary bypass surgery (CABG)

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	15.2%
Readmitted within 30 days: heart attack	13.2%
Readmitted within 30 days: heart failure	20%
Readmitted within 30 days: pneumonia	16.7%
Readmitted within 30 days: COPD	19.6%
Readmitted within 30 days: hip or knee replacement	6.1%
Not reported to Medicare	Readmitted within 30 days: coronary bypass surgery

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	Very high (60,000 or more)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	196 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	1%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	83%National average: 66%

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

Medicare payment programs

Medicare (CMS) uses these federal programs to adjust what it pays hospitals, based on quality, safety and cost results. This is a payment to the hospital for Medicare patients, not a price you pay, and not a prediction for any one person. Results for Scripps Memorial Hospital - Encinitas, fiscal year 2026 (October 2025 to September 2026).

Show the Medicare payment program results

Hospital-Acquired Condition Reduction Program

What this means: Medicare gives each hospital a Total HAC Score built from patient-safety complications and from infections caught in the hospital. The quarter of hospitals with the highest (worst) scores gets a reduction in its Medicare payments. A lower score is better.

CMS says: Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction.

Medicare payment reduction, fiscal year 2026	NoCMS lists no payment reduction for this hospital.
Total HAC Score	-0.3285Lower is better. Hospitals above the 75th percentile of all scores get the reduction.

Source: Hospital-Acquired Condition (HAC) Reduction Program — CMS, released January 26, 2026; patient-safety data from July 2022 to June 2024 and infection data from January 2023 to December 2024.

Hospital Readmissions Reduction Program

What this means: For six conditions, Medicare compares how often this hospital’s patients had to go back into a hospital within 30 days with how often that happens at an average hospital with similar patients. The ratio is that comparison: 1 means as many readmissions as expected, above 1 means more than expected (CMS calls these “excess readmissions”), below 1 means fewer.

CMS says: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP).

Heart attack	0.9277Fewer readmissions than expected
Heart failure	0.9132Fewer readmissions than expected
Pneumonia	0.9157Fewer readmissions than expected
COPD (chronic lung disease)	1.0138More readmissions than expected
Hip or knee replacement	1.2588More readmissions than expected
No result published	Coronary bypass surgery (CABG) (not reported, or too few cases)

Source: Hospital Readmissions Reduction Program — CMS, released January 26, 2026; patients discharged July 2021 to June 2024.

Hospital Value-Based Purchasing Program

What this means: Medicare scores hospitals in four areas, each from 0 to 100, and combines them into a Total Performance Score from 0 to 100. A higher score means better results on these measures. Medicare uses the score to adjust what it pays the hospital.

CMS says: This program adjusts payments to hospitals under the Inpatient Prospective Payment System (IPPS) based on the quality of care they deliver.

Total Performance Score	48.42 out of 100Median of the 2,455 hospitals in the program: 29.50
Clinical outcomes (deaths and complications)	56.00 out of 100
Person and community engagement (patient survey)	51.00 out of 100
Safety (infections and sepsis care)	56.67 out of 100
Efficiency and cost reduction (Medicare spending)	30.00 out of 100

Source: Hospital Value-Based Purchasing (HVBP) - Total Performance Score — CMS, released January 26, 2026, fiscal year 2026. Program description: The Hospital Value-Based Purchasing (VBP) Program — CMS, page last modified September 10, 2024.

Medicare spending per patient (MSPB)

What this means: This compares what Medicare spent on a hospital stay, counting the 3 days before it and the 30 days after, with the national median hospital, after adjusting for the patient’s age and health and for local prices. A ratio of 1.00 is the national median hospital; below 1.00 means Medicare spent less, above 1.00 means more. It measures the cost to Medicare, not the quality of care.

CMS says: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally.

Medicare spending per patient, ratio	0.94Below the national median hospital (1.00): Medicare spent less

Source: Medicare Spending Per Beneficiary - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in California Best hospitals in California

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 58 common services exactly as Scripps Memorial Hospital - Encinitas lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

$ 4 amounts are marked with “!”: they are more than 100 times higher or lower than what other hospitals list for the same service, which usually means an error or a different unit in the hospital’s file. They are shown exactly as listed; ask the hospital before relying on them.

Show the prices of 58 common services

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient or outpatient In the file: HC G-Tube Removal Only	$293.71	$73.43	$23.50 – $428.09
Established patient office visit (about 20–29 minutes): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $74.01 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $97.81 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $171.24 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $88.11 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $176.37 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $171.24 BC [814] — BLUE CROSS HMO: $61.97 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $171.24 BLUE CROSS [220] — BLUE CROSS HMO: $61.97 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $61.97
Emergency room visit (moderate) CPT 99283 · Inpatient or outpatient In the file: HC ER Level III	$2,414.77	$603.69	$69.85 – $2,173.29
Emergency room visit (moderate): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $2,069.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $2,069.46 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $351.09 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $69.85 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $361.63 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $351.09 BC [814] — BLUE CROSS HMO: $1,970.45 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $351.09 BLUE CROSS [220] — BLUE CROSS HMO: $1,970.45 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,970.45
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER Level IV	$3,884.63	$971.16	$118.58 – $3,496.17
Emergency room visit (moderately high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,329.13 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,329.13 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $536.67 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $118.58 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $552.77 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $536.67 BC [814] — BLUE CROSS HMO: $3,169.86 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $536.67 BLUE CROSS [220] — BLUE CROSS HMO: $3,169.86 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $3,169.86
Emergency room visit (moderately high) CPT 99284 · Inpatient or outpatient In the file: HC ER Level IV Trauma	$19,633.13	$4,908.28	$118.58 – $17,669.82
Emergency room visit (moderately high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $16,825.59 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $16,825.59 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $536.67 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $118.58 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $552.77 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $536.67 BC [814] — BLUE CROSS HMO: $16,020.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $536.67 BLUE CROSS [220] — BLUE CROSS HMO: $16,020.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $16,020.63
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER Level V	$7,874.25	$1,968.56	$172.27 – $7,086.83
Emergency room visit (high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $6,748.23 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $6,748.23 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $765.95 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $172.27 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $788.93 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $765.95 BC [814] — BLUE CROSS HMO: $6,425.39 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $765.95 BLUE CROSS [220] — BLUE CROSS HMO: $6,425.39 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $6,425.39
Emergency room visit (high) CPT 99285 · Inpatient or outpatient In the file: HC ER Level V Trauma	$23,622.75	$5,905.69	$172.27 – $21,260.48
Emergency room visit (high): 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $20,244.70 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $20,244.70 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $765.95 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $172.27 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $788.93 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $765.95 BC [814] — BLUE CROSS HMO: $19,276.16 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $765.95 BLUE CROSS [220] — BLUE CROSS HMO: $19,276.16 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $19,276.16

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: HC Basic Metabolic Panel	$244	$61	$8.46 – $195.20
Basic metabolic panel (blood test): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $110.78 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $122.98 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $8.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $8.46 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $8.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $8.46 BC [814] — BLUE CROSS HMO: $53.92 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $8.46 BLUE CROSS [220] — BLUE CROSS HMO: $53.92 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $51.48
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient · modifier TC In the file: HC Basic Metabolic Panel\|TECHNICAL COMPONENT	$244	$61	$8.46 – $195.20
Basic metabolic panel (blood test): rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $39.04 MC BLUE CROSS [901] — SHPS SHEN: $39.04 MC BLUE SHIELD [902] — SHPS SHEN: $39.04 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $39.04 MC CIGNA [903] — SHPS SHEN: $39.04 MC HEALTH NET [904] — SHPS SHEN: $39.04 MC SCAN [905] — SHPS SHEN: $39.04 MC UNITED [906] — SHPS SHEN: $39.04
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Comprehensive Panel	$391.99	$98	$10.56 – $313.59
Comprehensive metabolic panel (blood test): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $177.96 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $197.56 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $10.56 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $10.56 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $10.88 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $10.56 BC [814] — BLUE CROSS HMO: $86.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $10.56 BLUE CROSS [220] — BLUE CROSS HMO: $86.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $82.71
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: HC Metabolic Pnl,Comp, Wb	$391.99	$98	$10.56 – $313.59
Comprehensive metabolic panel (blood test): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $177.96 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $197.56 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $10.56 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $10.56 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $10.88 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $10.56 BC [814] — BLUE CROSS HMO: $86.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $10.56 BLUE CROSS [220] — BLUE CROSS HMO: $86.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $82.71
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient · modifier TC In the file: HC Comprehensive Panel\|TECHNICAL COMPONENT	$391.99	$98	$10.56 – $313.59
Comprehensive metabolic panel (blood test): rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $58.80 MC BLUE CROSS [901] — SHPS SHEN: $58.80 MC BLUE SHIELD [902] — SHPS SHEN: $58.80 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $58.80 MC CIGNA [903] — SHPS SHEN: $58.80 MC HEALTH NET [904] — SHPS SHEN: $58.80 MC SCAN [905] — SHPS SHEN: $58.80 MC UNITED [906] — SHPS SHEN: $58.80
Obstetric blood test panel CPT 80055 · Inpatient or outpatient In the file: HC Obstetric Panel	$348.08	$87.02	$27.85 – $278.46
Obstetric blood test panel: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $158.03 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $175.43 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $47.81 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $47.81 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $49.24 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $47.81 BC [814] — BLUE CROSS HMO: $76.93 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $47.81 BLUE CROSS [220] — BLUE CROSS HMO: $76.93 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $73.44
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: HC Renal Function Panel	$88	$22	$7.04 – $70.40
Kidney function panel: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $39.95 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $44.35 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $8.68 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $8.68 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $8.94 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $8.68 BC [814] — BLUE CROSS HMO: $19.45 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $8.68 BLUE CROSS [220] — BLUE CROSS HMO: $19.45 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $18.57
Kidney function panel CPT 80069 · Inpatient or outpatient · modifier TC In the file: HC Renal Function Panel\|TECHNICAL COMPONENT	$88	$22	$7.04 – $70.40
Kidney function panel: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $14.08 MC BLUE CROSS [901] — SHPS SHEN: $14.08 MC BLUE SHIELD [902] — SHPS SHEN: $14.08 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $14.08 MC CIGNA [903] — SHPS SHEN: $14.08 MC HEALTH NET [904] — SHPS SHEN: $14.08 MC SCAN [905] — SHPS SHEN: $14.08 MC UNITED [906] — SHPS SHEN: $14.08
Liver function panel CPT 80076 · Inpatient or outpatient In the file: HC Hepatic Fx Panel	$284.84	$71.21	$8.17 – $227.87
Liver function panel: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $129.32 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $143.56 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $8.17 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $8.17 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $8.42 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $8.17 BC [814] — BLUE CROSS HMO: $62.95 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $8.17 BLUE CROSS [220] — BLUE CROSS HMO: $62.95 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $60.10
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: HC Urinalysis-Complete	$141.43	$35.36	$3.17 – $113.14
Urine test (automated, with microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $64.21 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $71.28 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $3.17 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.17 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $3.27 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $3.17 BC [814] — BLUE CROSS HMO: $31.26 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $3.17 BLUE CROSS [220] — BLUE CROSS HMO: $31.26 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $29.84
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Urinalysis Dipstick/Reducing/Sub/Ph	$19.08	$4.77	$1.53 – $15.26
Urine test (manual, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $8.66 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $9.62 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $3.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.48 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $3.58 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $3.48 BC [814] — BLUE CROSS HMO: $4.22 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $3.48 BLUE CROSS [220] — BLUE CROSS HMO: $4.22 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4.03
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Dipstick Urine	$21.09	$5.27	$1.69 – $16.87
Urine test (manual, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $9.57 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $10.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $3.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.48 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $3.58 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $3.48 BC [814] — BLUE CROSS HMO: $4.66 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $3.48 BLUE CROSS [220] — BLUE CROSS HMO: $4.66 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4.45
Urine test (manual, without microscope) CPT 81002 · Inpatient or outpatient In the file: HC Phurine	$19.08	$4.77	$1.53 – $15.26
Urine test (manual, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $8.66 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $9.62 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $3.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $3.48 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $3.58 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $3.48 BC [814] — BLUE CROSS HMO: $4.22 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $3.48 BLUE CROSS [220] — BLUE CROSS HMO: $4.22 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4.03
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Sp Gravity	$65.03	$16.26	$2.25 – $52.02
Urine test (automated, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $29.52 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $32.78 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $2.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $2.25 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $2.32 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $2.25 BC [814] — BLUE CROSS HMO: $14.37 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $2.25 BLUE CROSS [220] — BLUE CROSS HMO: $14.37 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $13.72
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urinalysis Macro/Sp Gravity	$84.77	$21.19	$2.25 – $67.82
Urine test (automated, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $38.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $42.72 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $2.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $2.25 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $2.32 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $2.25 BC [814] — BLUE CROSS HMO: $18.73 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $2.25 BLUE CROSS [220] — BLUE CROSS HMO: $18.73 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $17.89
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: HC Urine Screen	$65.03	$16.26	$2.25 – $52.02
Urine test (automated, without microscope): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $29.52 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $32.78 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $2.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $2.25 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $2.32 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $2.25 BC [814] — BLUE CROSS HMO: $14.37 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $2.25 BLUE CROSS [220] — BLUE CROSS HMO: $14.37 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $13.72
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: HC Psa Antigen (Psa Screen)	$126	$31.50	$10.08 – $100.80
PSA (prostate specific antigen) blood test: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $57.20 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $63.50 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $18.39 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $18.39 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $18.94 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $18.39 BC [814] — BLUE CROSS HMO: $27.85 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $18.39 BLUE CROSS [220] — BLUE CROSS HMO: $27.85 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $26.59
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: HC Tsh	$134.32	$33.58	$10.75 – $107.46
Thyroid stimulating hormone (TSH) test: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $60.98 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $67.70 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $16.80 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $16.80 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $17.30 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $16.80 BC [814] — BLUE CROSS HMO: $29.68 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $16.80 BLUE CROSS [220] — BLUE CROSS HMO: $29.68 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $28.34
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: HC Cbc	$110	$27.50	$7.77 – $88
Complete blood count (CBC) with differential: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $49.94 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $55.44 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $7.77 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $7.77 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $8 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $7.77 BC [814] — BLUE CROSS HMO: $24.31 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $7.77 BLUE CROSS [220] — BLUE CROSS HMO: $24.31 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $23.21
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient · modifier TC In the file: HC Cbc\|TECHNICAL COMPONENT	$110	$27.50	$7.77 – $88
Complete blood count (CBC) with differential: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $16.50 MC BLUE CROSS [901] — SHPS SHEN: $16.50 MC BLUE SHIELD [902] — SHPS SHEN: $16.50 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $16.50 MC CIGNA [903] — SHPS SHEN: $16.50 MC HEALTH NET [904] — SHPS SHEN: $16.50 MC SCAN [905] — SHPS SHEN: $16.50 MC UNITED [906] — SHPS SHEN: $16.50
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: HC Hemogram	$151.63	$37.91	$6.47 – $121.30
Complete blood count (CBC), automated: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $68.84 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $76.42 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $6.47 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $6.47 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $6.66 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $6.47 BC [814] — BLUE CROSS HMO: $33.51 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $6.47 BLUE CROSS [220] — BLUE CROSS HMO: $33.51 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $31.99
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient · modifier TC In the file: HC Hemogram\|TECHNICAL COMPONENT	$151.63	$37.91	$6.47 – $121.30
Complete blood count (CBC), automated: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $22.74 MC BLUE CROSS [901] — SHPS SHEN: $22.74 MC BLUE SHIELD [902] — SHPS SHEN: $22.74 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $22.74 MC CIGNA [903] — SHPS SHEN: $22.74 MC HEALTH NET [904] — SHPS SHEN: $22.74 MC SCAN [905] — SHPS SHEN: $22.74 MC UNITED [906] — SHPS SHEN: $22.74
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: HC Prothrombin Time	$103	$25.75	$4.29 – $82.40
Blood clotting time test (prothrombin time, PT): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $46.76 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $51.91 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $4.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $4.29 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $4.42 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $4.29 BC [814] — BLUE CROSS HMO: $22.76 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $4.29 BLUE CROSS [220] — BLUE CROSS HMO: $22.76 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $21.73
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: HC Aptt	$135	$33.75	$6.01 – $108
Blood clotting test (partial thromboplastin time, PTT): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $61.29 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $68.04 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $6.01 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $6.01 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $6.19 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $6.01 BC [814] — BLUE CROSS HMO: $29.84 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $6.01 BLUE CROSS [220] — BLUE CROSS HMO: $29.84 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $28.49
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient · modifier TC In the file: HC Aptt\|TECHNICAL COMPONENT	$135	$33.75	$6.01 – $108
Blood clotting test (partial thromboplastin time, PTT): rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $21.60 MC BLUE CROSS [901] — SHPS SHEN: $21.60 MC BLUE SHIELD [902] — SHPS SHEN: $21.60 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $21.60 MC CIGNA [903] — SHPS SHEN: $21.60 MC HEALTH NET [904] — SHPS SHEN: $21.60 MC SCAN [905] — SHPS SHEN: $21.60 MC UNITED [906] — SHPS SHEN: $21.60

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: HC CT Head WO	$3,457.62	$864.40	$62.46 – $2,766.10
CT scan of the head or brain, without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $698.44 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $698.44 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $80.08 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $134.46 BC [814] — BLUE CROSS HMO: $598.17 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $598.17 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $598.17
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: HC MR Brain W/WO	$5,902.98	$1,475.74	$197.04 – $4,722.38
MRI of the brain, before and after contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,192.40 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,192.40 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $448.71 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $252.61 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $462.17 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $448.71 BC [814] — BLUE CROSS HMO: $1,021.22 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $448.71 BLUE CROSS [220] — BLUE CROSS HMO: $1,021.22 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,021.22
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: HC Chest 2 Views	$974.59	$243.65	$27.35 – $779.67
Chest X-ray, 2 views: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $442.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $491.19 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $111.93 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $27.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $115.29 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $111.93 BC [814] — BLUE CROSS HMO: $215.38 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 BLUE CROSS [220] — BLUE CROSS HMO: $215.38 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $205.64
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier FY In the file: HC Chest 2 Views\|X RAY COMPUTED RADIOGRAPHY	$974.59	$243.65	$27.35 – $779.67
Chest X-ray, 2 views: 10 of 71 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $111.93 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $115.29 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $111.93 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHEN: $111.93 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHEN: $111.93
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient · modifier TC In the file: HC Chest 2 Views\|TECHNICAL COMPONENT	$974.59	$243.65	$27.35 – $779.67
Chest X-ray, 2 views: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $155.93 MC BLUE CROSS [901] — SHPS SHEN: $155.93 MC BLUE SHIELD [902] — SHPS SHEN: $155.93 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $155.93 MC CIGNA [903] — SHPS SHEN: $155.93 MC HEALTH NET [904] — SHPS SHEN: $155.93 MC SCAN [905] — SHPS SHEN: $155.93 MC UNITED [906] — SHPS SHEN: $155.93
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: HC Spine L-S Min 4vw	$1,168.13	$292.03	$48.52 – $934.50
X-ray of the lower spine, at least 4 views: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $530.33 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $588.74 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $48.52 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $134.46 BC [814] — BLUE CROSS HMO: $258.16 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $258.16 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $246.48
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient · modifier FY In the file: HC Spine L-S Min 4vw\|X RAY COMPUTED RADIOGRAPHY	$1,168.13	$292.03	$48.52 – $934.50
X-ray of the lower spine, at least 4 views: 10 of 63 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $134.46 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $134.46 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHEN: $134.46
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: HC MR Lumbar WO	$3,013	$753.25	$114.64 – $2,410.40
MRI of the lower back (lumbar spine), without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $608.63 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $608.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $306.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $146.97 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $316.09 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $306.88 BC [814] — BLUE CROSS HMO: $521.25 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $306.88 BLUE CROSS [220] — BLUE CROSS HMO: $521.25 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $521.25
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient · modifier TC In the file: HC MR Lumbar WO\|TECHNICAL COMPONENT	$3,013	$753.25	$114.64 – $2,410.40
MRI of the lower back (lumbar spine), without contrast: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $241.04 MC BLUE CROSS [901] — SHPS SHEN: $241.04 MC BLUE SHIELD [902] — SHPS SHEN: $241.04 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $241.04 MC CIGNA [903] — SHPS SHEN: $241.04 MC HEALTH NET [904] — SHPS SHEN: $241.04 MC SCAN [905] — SHPS SHEN: $241.04 MC UNITED [906] — SHPS SHEN: $241.04
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: HC CT Pelvis W	$2,920.22	$730.05	$160.44 – $2,336.18
CT scan of the pelvis, with contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $589.88 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $589.88 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $225.59 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $205.69 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $232.36 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $225.59 BC [814] — BLUE CROSS HMO: $505.20 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $225.59 BLUE CROSS [220] — BLUE CROSS HMO: $505.20 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $505.20
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MR Jnt Low Ext WO Unilat	$3,780.92	$945.23	$131.77 – $3,024.74
MRI of a leg joint (such as the knee), without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $763.75 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $763.75 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $306.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $168.94 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $316.09 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $306.88 BC [814] — BLUE CROSS HMO: $654.10 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $306.88 BLUE CROSS [220] — BLUE CROSS HMO: $654.10 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $654.10
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient In the file: HC MRI Any Jt Lower Extrem W/O Contrast Matrl Bilateral	$6,628.43	$1,657.11	$131.77 – $5,302.74
MRI of a leg joint (such as the knee), without contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,338.94 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,338.94 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $306.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $168.94 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $316.09 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $306.88 BC [814] — BLUE CROSS HMO: $1,146.72 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $306.88 BLUE CROSS [220] — BLUE CROSS HMO: $1,146.72 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,146.72
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier 50 In the file: HC MR Jnt Low Ext WO Unilat\|BILATERAL PROCEDURE	$3,780.92	$945.23	$131.77 – $3,024.74
MRI of a leg joint (such as the knee), without contrast: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $264.66 MC BLUE CROSS [901] — SHPS SHEN: $264.66 MC BLUE SHIELD [902] — SHPS SHEN: $264.66 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $264.66 MC CIGNA [903] — SHPS SHEN: $264.66 MC HEALTH NET [904] — SHPS SHEN: $264.66 MC SCAN [905] — SHPS SHEN: $264.66 MC UNITED [906] — SHPS SHEN: $264.66
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: HC CT Abdomen & Pelvis W	$9,000	$2,250	$201.57 – $7,200
CT scan of the abdomen and pelvis, with contrast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,818 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,818 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $448.71 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $258.42 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $462.17 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $448.71 BC [814] — BLUE CROSS HMO: $1,557 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $448.71 BLUE CROSS [220] — BLUE CROSS HMO: $1,557 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,557
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: HC US Abdomen Complete	$1,369.44	$342.36	$91.44 – $1,095.55
Ultrasound of the abdomen, complete: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $621.73 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $690.20 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $91.44 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $134.46 BC [814] — BLUE CROSS HMO: $302.65 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $302.65 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $288.95
Pregnancy ultrasound (after the first trimester) CPT 76805 · Inpatient or outpatient In the file: HC US Preg>14 Wks Sgl Ges	$909.04	$227.26	$72.72 – $727.23
Pregnancy ultrasound (after the first trimester): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $412.70 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $458.16 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.82 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $134.46 BC [814] — BLUE CROSS HMO: $200.90 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $200.90 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $191.81
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: HC US Transvaginal	$1,615.79	$403.95	$101.43 – $1,292.63
Transvaginal ultrasound: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $733.57 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $814.36 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $134.46 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $101.43 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $138.50 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $134.46 BC [814] — BLUE CROSS HMO: $357.09 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $134.46 BLUE CROSS [220] — BLUE CROSS HMO: $357.09 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $340.93
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient · modifier TC In the file: HC US Transvaginal\|TECHNICAL COMPONENT	$1,615.79	$403.95	$101.43 – $1,292.63
Transvaginal ultrasound: 10 of 12 insurance plan rates MC ALIGNMENT [917] — SHPS SHEN: $274.68 MC BLUE CROSS [901] — SHPS SHEN: $274.68 MC BLUE SHIELD [902] — SHPS SHEN: $274.68 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $274.68 MC CIGNA [903] — SHPS SHEN: $274.68 MC HEALTH NET [904] — SHPS SHEN: $274.68 MC SCAN [905] — SHPS SHEN: $274.68 MC UNITED [906] — SHPS SHEN: $274.68 MPMG [800] — MPMG: $134.46 MPMG MCR ADV [836] — MPMG: $134.46
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient In the file: HC Dx Uni Mammo Incl Cad	$671.99	$168	$53.76 – $537.59
Diagnostic mammogram, one breast: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $305.08 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $338.68 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $102.85 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $102.85 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $105.94 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $102.85 BC [814] — BLUE CROSS HMO: $148.51 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $102.85 BLUE CROSS [220] — BLUE CROSS HMO: $148.51 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $141.79
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: HC Dx Bilat Mammo Incl Cad	$897.82	$224.45	$71.83 – $718.26
Diagnostic mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $407.61 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $452.50 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $131.79 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $131.79 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $135.74 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $131.79 BC [814] — BLUE CROSS HMO: $198.42 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $131.79 BLUE CROSS [220] — BLUE CROSS HMO: $198.42 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $189.44
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient · modifier TC In the file: HC Dx Bilat Mammo Incl Cad\|TECHNICAL COMPONENT	$897.82	$224.45	$71.83 – $718.26
Diagnostic mammogram, both breasts: rates for 8 insurance plans MC ALIGNMENT [917] — SHPS SHEN: $188.54 MC BLUE CROSS [901] — SHPS SHEN: $188.54 MC BLUE SHIELD [902] — SHPS SHEN: $188.54 MC BLUE SHIELD PROMISE HEALTH PLAN [914] — SHPS SHEN: $188.54 MC CIGNA [903] — SHPS SHEN: $188.54 MC HEALTH NET [904] — SHPS SHEN: $188.54 MC SCAN [905] — SHPS SHEN: $188.54 MC UNITED [906] — SHPS SHEN: $188.54
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scrn Uni Mammo Ximg W/Cad	$723.47	$180.87	$57.88 – $578.78
Screening mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $328.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $364.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $108.84 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $108.84 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $112.11 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $108.84 BC [814] — BLUE CROSS HMO: $159.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $108.84 BLUE CROSS [220] — BLUE CROSS HMO: $159.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $152.65
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scrn Uni Mammo Incl Cad	$723.47	$180.87	$57.88 – $578.78
Screening mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $328.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $364.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $108.84 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $108.84 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $112.11 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $108.84 BC [814] — BLUE CROSS HMO: $159.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $108.84 BLUE CROSS [220] — BLUE CROSS HMO: $159.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $152.65
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient In the file: HC Scrn Bilat Mammo Incl Cad	$723.47	$180.87	$57.88 – $578.78
Screening mammogram, both breasts: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $328.46 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $364.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $108.84 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $108.84 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $112.11 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $108.84 BC [814] — BLUE CROSS HMO: $159.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $108.84 BLUE CROSS [220] — BLUE CROSS HMO: $159.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $152.65

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Sleep study (overnight, in a sleep lab) CPT 95810 · Inpatient or outpatient In the file: HC Poly 4 or More Para Atted	$2,313.49	$578.37	$185.08 – $2,761.21
Sleep study (overnight, in a sleep lab): 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,050.32 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,166 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,104.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $659.45 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,137.62 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,104.48 BC [814] — BLUE CROSS HMO: $511.28 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,104.48 BLUE CROSS [220] — BLUE CROSS HMO: $511.28 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $488.15

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient In the file: HC Ther Ex 15 Min	$172.80	$43.20	$13.82 – $138.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $78.45 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $87.09 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $32.04 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $33 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $32.04 BC [814] — BLUE CROSS HMO: $38.19 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE CROSS [220] — BLUE CROSS HMO: $38.19 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $36.46
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier CO In the file: HC Ther Ex 15 Min\|OP OCCUPATIONAL THERAPY SERV BY COTA	$172.80	$43.20	$13.82 – $138.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 63 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $32.04 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $33 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $32.04 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHEN: $32.04
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier CQ In the file: HC Ther Ex 15 Min\|OP PT SERVICES BY PTA	$172.80	$43.20	$13.82 – $138.24
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 63 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $32.04 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $33 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $32.04 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHEN: $32.04 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHEN: $32.04
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient In the file: HC Pt Eval Low Complexity	$218.88	$54.72	$17.51 – $270.73
Physical therapy evaluation (low complexity): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $99.37 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $110.32 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $108.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $111.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $108.29 BC [814] — BLUE CROSS HMO: $48.37 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $108.29 BLUE CROSS [220] — BLUE CROSS HMO: $48.37 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $46.18
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient In the file: HC Pt Eval Mod Complexity	$248.26	$62.06	$19.86 – $270.73
Physical therapy evaluation (moderate complexity): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $112.71 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $125.12 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $108.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $111.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $108.29 BC [814] — BLUE CROSS HMO: $54.87 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $108.29 BLUE CROSS [220] — BLUE CROSS HMO: $54.87 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $52.38
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient In the file: HC Pt Eval High Complexity	$279.36	$69.84	$22.35 – $270.73
Physical therapy evaluation (high complexity): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $126.83 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $140.80 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $108.29 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $50 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $111.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $108.29 BC [814] — BLUE CROSS HMO: $61.74 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $108.29 BLUE CROSS [220] — BLUE CROSS HMO: $61.74 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $58.94

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: HC Excise Brst Les =>1 Uni	$15,935.77	$3,983.94	$424.09 – $12,748.62
Removal of breast growth (open surgery): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,219.03 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,219.03 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $5,035.90 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $424.09 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $5,186.98 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $5,035.90 BC [814] — BLUE CROSS HMO: $2,756.89 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $5,035.90 BLUE CROSS [220] — BLUE CROSS HMO: $2,756.89 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,756.89
Removal of breast growth (open surgery) CPT 19120 · Inpatient or outpatient In the file: HC Excise Brst Les =>1 Bil	$23,958.14	$5,989.53	$424.09 – $19,166.51
Removal of breast growth (open surgery): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $4,839.54 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $4,839.54 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $5,035.90 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $424.09 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $5,186.98 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $5,035.90 BC [814] — BLUE CROSS HMO: $4,144.76 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $5,035.90 BLUE CROSS [220] — BLUE CROSS HMO: $4,144.76 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4,144.76
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Inpatient or outpatient In the file: HC Arthroscopy Shldr Decomp	$17,253	$4,313.25	$147.65 – $13,802.40
Shoulder arthroscopy: shaving of shoulder bone: 10 of 70 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,485.11 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,485.11 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $147.65 BC [814] — BLUE CROSS HMO: $2,984.77 BLUE CROSS [220] — BLUE CROSS HMO: $2,984.77 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,984.77 BLUE CROSS [220] — BLUE CROSS PPO MCS: $3,278.07 BLUE CROSS [220] — BLUE CROSS PPO NON-MCS: $2,984.77 BLUE CROSS BLUE SHIELD [233] — BLUE CROSS HMO: $2,984.77 BLUE CROSS BLUE SHIELD [233] — BLUE CROSS PPO NON-MCS: $2,984.77
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Inpatient or outpatient In the file: HC Knee Meniscec Med or Lat	$11,855.97	$2,963.99	$548.23 – $10,520.85
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $2,394.91 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $2,394.91 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $4,208.34 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $548.23 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $4,334.59 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $4,208.34 BC [814] — BLUE CROSS HMO: $2,051.08 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $4,208.34 BLUE CROSS [220] — BLUE CROSS HMO: $2,051.08 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,051.08
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: HC Egd Diag Brush/Wash	$2,901.60	$725.40	$115.67 – $2,916.34
Upper GI endoscopy (diagnostic): 10 of 136 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $2,486.67 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $2,486.67 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,166.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $115.67 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,201.53 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,166.53 BC [814] — BLUE CROSS HMO: $641.25 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,166.53 BLUE CROSS [220] — BLUE CROSS HMO: $2,367.71 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,367.71
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: HC Egd Diag W/Fmt	$2,901.60	$725.40	$115.67 – $2,916.34
Upper GI endoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $731.20 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $966.23 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,166.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $115.67 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,201.53 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,166.53 BC [814] — BLUE CROSS HMO: $641.25 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,166.53 BLUE CROSS [220] — BLUE CROSS HMO: $641.25 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $612.24
Upper GI endoscopy with biopsy CPT 43239 · Inpatient or outpatient In the file: HC Egd W/Biopsy Sgl/Mult	$2,597.40	$649.35	$128.99 – $2,916.34
Upper GI endoscopy with biopsy: 10 of 136 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $654.54 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $864.93 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,166.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $128.99 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,201.53 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,166.53 BC [814] — BLUE CROSS HMO: $574.03 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,166.53 BLUE CROSS [220] — BLUE CROSS HMO: $2,119.48 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,119.48
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: HC Colonoscpy	$2,997.98	$749.49	$170.35 – $2,990.20
Colonoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $755.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $998.33 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,196.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $170.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,231.96 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,196.08 BC [814] — BLUE CROSS HMO: $662.55 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,196.08 BLUE CROSS [220] — BLUE CROSS HMO: $662.55 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $632.57
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: HC Diagnostic Colonoscopy	$2,997.98	$749.49	$170.35 – $2,990.20
Colonoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $605.59 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $605.59 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,196.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $170.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,231.96 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,196.08 BC [814] — BLUE CROSS HMO: $518.65 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,196.08 BLUE CROSS [220] — BLUE CROSS HMO: $518.65 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $518.65
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: HC Colonoscopy W/Fmt	$2,997.98	$749.49	$170.35 – $2,990.20
Colonoscopy (diagnostic): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $755.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $998.33 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,196.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $170.35 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,231.96 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,196.08 BC [814] — BLUE CROSS HMO: $662.55 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,196.08 BLUE CROSS [220] — BLUE CROSS HMO: $662.55 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $632.57
Colonoscopy with biopsy CPT 45380 · Inpatient or outpatient In the file: HC Colonoscopy W/Biopsy	$3,887.40	$971.85	$184.11 – $3,847.70
Colonoscopy with biopsy: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $979.62 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,294.50 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,539.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $184.11 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,585.25 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,539.08 BC [814] — BLUE CROSS HMO: $859.12 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,539.08 BLUE CROSS [220] — BLUE CROSS HMO: $859.12 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $820.24
Colonoscopy with removal of polyps (snare) CPT 45385 · Inpatient or outpatient In the file: HC Colonoscpy Tum/Pol/Les Sr	$3,385.34	$846.33	$231.38 – $3,847.70
Colonoscopy with removal of polyps (snare): 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $853.11 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,127.32 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,539.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $231.38 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,585.25 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,539.08 BC [814] — BLUE CROSS HMO: $748.16 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,539.08 BLUE CROSS [220] — BLUE CROSS HMO: $748.16 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $714.31
Ultrasound of the lower bowel by endoscope CPT 45391 · Inpatient or outpatient In the file: HC Colonscopy Endo US Exam	$3,691.96	$922.99	$234.68 – $3,847.70
Ultrasound of the lower bowel by endoscope: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $930.37 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,229.42 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,539.08 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $234.68 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,585.25 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,539.08 BC [814] — BLUE CROSS HMO: $815.92 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,539.08 BLUE CROSS [220] — BLUE CROSS HMO: $815.92 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $779
Gallbladder removal by laparoscope CPT 47562 · Inpatient or outpatient In the file: HC Laparoscopy Surg Cholecystectomy	$49,754.53	$12,438.63	$640.87 – $39,803.62
Gallbladder removal by laparoscope: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $10,050.42 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $10,050.42 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $7,775.56 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $640.87 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $8,008.82 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $7,775.56 BC [814] — BLUE CROSS HMO: $8,607.53 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,775.56 BLUE CROSS [220] — BLUE CROSS HMO: $8,607.53 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $8,607.53
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: HC Prp I/Hern Init Reduc>5 R	$13,329.79	$3,332.45	$519.79 – $19,520.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 132 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $11,423.63 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $11,423.63 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $4,604.99 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $519.79 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $4,743.14 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $4,604.99 BC [814] — BLUE CROSS HMO: $10,877.11 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $4,604.99 BLUE CROSS [220] — BLUE CROSS HMO: $10,877.11 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $10,877.11
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient In the file: HC Rpr I/Hern Init Redc >5yr	$15,636.67	$3,909.17	$519.79 – $19,520.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $3,158.61 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $3,158.61 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $4,604.99 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $519.79 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $4,743.14 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $4,604.99 BC [814] — BLUE CROSS HMO: $2,705.14 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $4,604.99 BLUE CROSS [220] — BLUE CROSS HMO: $2,705.14 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $2,705.14
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Inpatient or outpatient · modifier 50 In the file: HC Prp I/Hern Init Reduc>5 R\|BILATERAL PROCEDURE	$13,329.79	$3,332.45	$519.79 – $19,520.47
Groin (inguinal) hernia repair, age 5 or older: 10 of 59 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $7,808.19 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $8,042.43 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $7,808.19 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,808.19 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,808.19 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,808.19 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,808.19 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,808.19 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHEN: $7,808.19 CIGNA MEDICARE ADVANTAGE [281] — MEDICARE HMO/PPO SHEN: $7,808.19
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Inpatient or outpatient In the file: HC Hysteroscopy Biopsy	$28,325.92	$7,081.48	$206.18 – $22,660.74
Hysteroscopy with biopsy of the uterus lining: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $5,721.84 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $5,721.84 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $4,163.48 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $206.18 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $4,288.39 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $4,163.48 BC [814] — BLUE CROSS HMO: $4,900.38 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $4,163.48 BLUE CROSS [220] — BLUE CROSS HMO: $4,900.38 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $4,900.38
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Inpatient or outpatient In the file: HC Inj Lumbr/Sacrl W Image	$2,071.74	$517.93	$93.19 – $2,269.70
Spinal injection, lower back (epidural), with imaging guidance: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $418.49 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $418.49 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $907.88 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $93.19 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $935.12 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $907.88 BC [814] — BLUE CROSS HMO: $358.41 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $907.88 BLUE CROSS [220] — BLUE CROSS HMO: $358.41 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $358.41
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Foramn Epi L/S 1lev	$2,277.28	$569.32	$105.07 – $2,843.95
Nerve root injection, lower back, with imaging guidance: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $460.01 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $460.01 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,137.58 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.07 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,171.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,137.58 BC [814] — BLUE CROSS HMO: $393.97 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,137.58 BLUE CROSS [220] — BLUE CROSS HMO: $393.97 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $393.97
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Inj Foramen Epi L/S 1 Lev, Bilateral	$4,554.55	$1,138.64	$105.07 – $3,643.64
Nerve root injection, lower back, with imaging guidance: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $920.02 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $920.02 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,137.58 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.07 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,171.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,137.58 BC [814] — BLUE CROSS HMO: $787.94 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,137.58 BLUE CROSS [220] — BLUE CROSS HMO: $787.94 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $787.94
Nerve root injection, lower back, with imaging guidance CPT 64483 · Inpatient or outpatient In the file: HC Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level	$2,277.28	$569.32	$105.07 – $2,843.95
Nerve root injection, lower back, with imaging guidance: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $460.01 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $460.01 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $1,137.58 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $105.07 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $1,171.71 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $1,137.58 BC [814] — BLUE CROSS HMO: $393.97 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $1,137.58 BLUE CROSS [220] — BLUE CROSS HMO: $393.97 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $393.97
Carpal tunnel release CPT 64721 · Inpatient or outpatient In the file: HC Neuroplasty Med Nrv Carp	$4,255.65	$1,063.91	$340.45 – $6,278.83
Carpal tunnel release: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $859.64 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $859.64 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $2,511.53 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $457.62 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $2,586.88 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $2,511.53 BC [814] — BLUE CROSS HMO: $736.23 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $2,511.53 BLUE CROSS [220] — BLUE CROSS HMO: $736.23 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $736.23
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: HC Discisn 2nd Cataract Lasr	$1,006.20	$251.55	$80.50 – $1,768.47
Laser treatment of clouding after cataract surgery: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $203.25 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $203.25 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $707.39 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $305.24 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $728.61 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $707.39 BC [814] — BLUE CROSS HMO: $174.07 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $707.39 BLUE CROSS [220] — BLUE CROSS HMO: $174.07 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $174.07
Laser treatment of clouding after cataract surgery CPT 66821 · Inpatient or outpatient In the file: HC Discisn 2nd Cataract Lasr V	$1,006.20	$251.55	$80.50 – $1,768.47
Laser treatment of clouding after cataract surgery: 10 of 133 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $203.25 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $203.25 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $707.39 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $305.24 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $728.61 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $707.39 BC [814] — BLUE CROSS HMO: $174.07 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $707.39 BLUE CROSS [220] — BLUE CROSS HMO: $174.07 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $174.07
Cataract removal with lens implant CPT 66984 · Inpatient or outpatient In the file: HC Cataract Rml W/Iol 1 Stg	$7,774.02	$1,943.50	$501.72 – $7,420.62
Cataract removal with lens implant: 10 of 129 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $1,570.35 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $1,570.35 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $2,968.25 AETNA OPTUM CARE NETWORK - SDPMG [809] — SPMG: $501.72 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $3,057.29 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $2,968.25 BC [814] — BLUE CROSS HMO: $1,344.91 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $2,968.25 BLUE CROSS [220] — BLUE CROSS HMO: $1,344.91 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $1,344.91

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	$696,555.91	$174,138.98	$9.78 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $185,119.92
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 126 insurance plan rates AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $94,460.54 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $94,460.54 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $94,460.54 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $94,460.54 BLUE CROSS BLUE SHIELD MCR ADV [231] — MEDICARE HMO/PPO W PASS THRU SHEN: $94,460.54 BLUE CROSS MEDICARE ADVANTAGE [222] — MEDICARE HMO/PPO W PASS THRU SHEN: $94,460.54 BLUE SHIELD MEDICARE ADVANTAGE [232] — MEDICARE HMO/PPO W PASS THRU SHEN: $94,460.54 BS MCR ADV [829] — MEDICARE HMO/PPO W PASS THRU SHEN: $94,460.54 CENTRAL HEALTH MCR ADV [441] — MEDICARE HMO/PPO W PASS THRU SHEN: $94,460.54 CIGNA [280] — CIGNA HMO PPO: $161,122.72
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	$173,609.71	$43,402.43	$1.93 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $52,946.38
Hip or knee replacement (major joint of the leg), without major complications: 10 of 123 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $22,430 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $22,430 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $18,801.14 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $18,801.14 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $18,801.14 BC [814] — BLUE CROSS HMO: $27,600.63 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $18,801.14 BLUE CROSS [220] — BLUE CROSS HMO: $27,600.63 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $16,164.18 BLUE CROSS [220] — BLUE CROSS PPO MCS: $52,946.38
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	$282,265.86	$70,566.46	$2.44 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $67,011.24
Neck (cervical) spinal fusion, without complications: 10 of 123 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $26,984 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $26,984 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $23,737.27 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $23,737.27 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $23,737.27 BC [814] — BLUE CROSS HMO: $34,932.56 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $23,737.27 BLUE CROSS [220] — BLUE CROSS HMO: $34,932.56 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $20,458.09 BLUE CROSS [220] — BLUE CROSS PPO MCS: $67,011.24
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	$140,517.65	$35,129.41	$1.24 (Far outside what other hospitals list for this service: probably an error in the hospital’s file. Ask the hospital.) – $45,914.58
Uterus and ovary surgery (not for cancer), without complications: 10 of 123 insurance plan rates AETNA [210] — AETNA HMO (GATEKEEPER): $32,060.93 AETNA [210] — AETNA PPO (NON-GATEKEEPER): $45,914.58 AETNA MEDICARE ADVANTAGE [212] — MEDICARE HMO/PPO SHEN: $12,171.47 ALIGNMENT HEALTH PLAN [443] — ALIGNMENT MEDICARE ADVANTAGE SHEN: $12,171.47 ASTIVA MCR ADV [464] — MEDICARE HMO/PPO SHEN: $12,171.47 BC [814] — BLUE CROSS HMO: $17,753.18 BC MCR ADV [830] — MEDICARE HMO/PPO W PASS THRU SHEN: $12,171.47 BLUE CROSS [220] — BLUE CROSS HMO: $17,753.18 BLUE CROSS [220] — BLUE CROSS HMO SELECT: $10,397.07 BLUE CROSS [220] — BLUE CROSS PPO MCS: $34,055.97

Source: Scripps Memorial Hospital - Encinitas’s standard charges file (apps.scripps.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 30, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Acute Care Hospital
Address	354 Santa Fe Drive, Encinitas, CA 92024
County	San Diego County
State	California
Phone	(760) 753‑6501
Emergency services	Yes
Ownership	Voluntary non-profit - Private
Medicare overall rating	4 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	050503
Name in Medicare records	SCRIPPS MEMORIAL HOSPITAL - ENCINITAS
Profile level	Medicare data + hospital website
Main phone on the hospital’s website	(760) 633‑6501^[4]
Name on the hospital’s website	Scripps Memorial Hospital Encinitas
Official website	scripps.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Scripps Memorial Hospital Encinitas - Address and Parking — scripps.org
Scripps Memorial Hospital Encinitas services — scripps.org
Scripps Memorial Hospital Encinitas Emergency Room — scripps.org
Scripps Memorial Hospital Encinitas - Address and Parking — scripps.org
Services — scripps.org
Stroke Quality Measures and Outcomes - Scripps Health — scripps.org
Stroke Treatment and Recovery - Scripps Health — scripps.org
Maternity Hospital Locations - San Diego - Scripps Health — scripps.org