▸ Hospital · CA · CCN 050077
Scripps Mercy Hospital
4077 FIFTH AVENUE, SAN DIEGO, CA, 050077
Compliance grade
C
70/100
Procedures tracked
149
of 209 target codes
Payers
15
with negotiated rates
Rates published
0
last crawl 2026-05-22
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 8 | $62,350 | $15,587 | $15,262 | $26,031 | $46,743 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 11 | $839.92 | $209.98 | $108.45 | $680.34 | $719.81 |
| ED visit level 2 | CPT | 99282 | 11 | $1,312.38 | $328.09 | $197.48 | $1,063.03 | $1,124.71 |
| ED visit level 3 | CPT | 99283 | 11 | $2,414.77 | $603.69 | $351.09 | $1,955.96 | $2,069.46 |
| ED visit level 4 | CPT | 99284 | 13 | $19,633 | $4,908.28 | $536.67 | $15,707 | $17,513 |
| ED visit level 5 | CPT | 99285 | 13 | $23,623 | $5,905.69 | $765.95 | $18,898 | $21,071 |
| Critical care, first hour | CPT | 99291 | 13 | $28,347 | $7,086.82 | $1,062.41 | $22,678 | $25,286 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 9 | $3,457.62 | $864.4 | $134.46 | $615.46 | $1,293.15 |
| CT head with contrast | CPT | 70460 | 9 | $3,761.61 | $940.4 | $207 | $669.57 | $1,406.84 |
| CT head with and without contrast | CPT | 70470 | 9 | $4,065.6 | $1,016.4 | $207 | $723.68 | $1,520.53 |
| CT neck with contrast | CPT | 70491 | 9 | $6,613.94 | $1,653.48 | $207 | $1,177.28 | $2,473.61 |
| MRI brain without contrast | CPT | 70551 | 9 | $3,652.13 | $913.03 | $306.88 | $650.08 | $1,365.9 |
| MRI brain with contrast | CPT | 70552 | 9 | $4,146.31 | $1,036.58 | $347 | $738.04 | $1,550.72 |
| MRI brain with and without contrast | CPT | 70553 | 10 | $5,902.98 | $1,475.74 | $347 | $756.45 | $2,207.71 |
| Chest X-ray single view | CPT | 71045 | 9 | $302.98 | $75.74 | $68.44 | $101.8 | $137.55 |
| Chest X-ray 2 views | CPT | 71046 | 9 | $974.59 | $243.65 | $111.93 | $341.11 | $442.46 |
| Chest X-ray 3 views | CPT | 71047 | 9 | $287.53 | $71.88 | $90.86 | $107.54 | $130.54 |
| CT chest without contrast | CPT | 71250 | 9 | $2,098.94 | $524.73 | $134.46 | $373.61 | $785 |
| CT chest with contrast | CPT | 71260 | 9 | $8,534.59 | $2,133.65 | $207 | $1,519.16 | $3,191.94 |
| CT chest with and without contrast | CPT | 71270 | 9 | $2,967.55 | $741.89 | $207 | $528.22 | $1,109.86 |
| MRI chest without contrast | CPT | 71550 | 10 | $2,543.04 | $635.76 | $306.88 | $399.83 | $951.1 |
| MRI chest with contrast | CPT | 71551 | 10 | $2,556.96 | $639.24 | $347 | $501.17 | $1,038.5 |
| MRI chest with and without contrast | CPT | 71552 | 10 | $2,570.88 | $642.72 | $347 | $459.9 | $961.51 |
| Lumbosacral spine X-ray | CPT | 72100 | 9 | $1,290.82 | $322.7 | $134.46 | $451.79 | $586.03 |
| CT cervical spine without contrast | CPT | 72125 | 9 | $6,900 | $1,725 | $134.46 | $1,228.2 | $2,580.6 |
| CT thoracic spine without contrast | CPT | 72128 | 9 | $2,202.05 | $550.51 | $134.46 | $391.96 | $823.57 |
| CT lumbar spine without contrast | CPT | 72131 | 9 | $1,919.23 | $479.81 | $134.46 | $341.62 | $717.79 |
| MRI cervical spine without contrast | CPT | 72141 | 10 | $5,028.48 | $1,257.12 | $306.88 | $621.04 | $1,880.65 |
| MRI thoracic spine without contrast | CPT | 72146 | 10 | $4,104.86 | $1,026.21 | $306.88 | $538.84 | $1,535.22 |
| MRI lumbar spine without contrast | CPT | 72148 | 10 | $3,013 | $753.25 | $306.88 | $441.66 | $1,126.86 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 10 | $3,240 | $810 | $347 | $519.45 | $1,211.76 |
| MRI cervical spine with and without contrast | CPT | 72156 | 10 | $6,648 | $1,662 | $347 | $822.76 | $2,486.35 |
| MRI lumbar spine with contrast | CPT | 72158 | 10 | $3,385.8 | $846.45 | $347 | $532.42 | $1,266.29 |
| CT pelvis without contrast | CPT | 72192 | 9 | $1,455.55 | $363.89 | $134.46 | $259.09 | $544.38 |
| CT pelvis with contrast | CPT | 72193 | 9 | $2,920.22 | $730.05 | $207 | $519.8 | $1,092.16 |
| Shoulder X-ray | CPT | 73030 | 11 | $1,458.43 | $364.61 | $111.93 | $385.03 | $662.13 |
| Humerus X-ray | CPT | 73060 | 12 | $1,689.98 | $422.49 | $111.93 | $394.62 | $767.25 |
| Hand X-ray 3 views | CPT | 73130 | 9 | $1,638.18 | $409.54 | $111.93 | $431.39 | $743.73 |
| MRI upper extremity joint without contrast | CPT | 73221 | 10 | $3,468.86 | $867.21 | $306.88 | $439.39 | $1,297.35 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 10 | $6,489 | $1,622.25 | $347 | $808.61 | $2,426.89 |
| Knee X-ray 1-2 views | CPT | 73560 | 10 | $423.18 | $105.79 | $89.15 | $133.72 | $192.12 |
| Ankle X-ray 3 views | CPT | 73610 | 9 | $1,365.04 | $341.26 | $111.93 | $359.46 | $619.73 |
| MRI lower extremity joint without contrast | CPT | 73721 | 12 | $6,628.43 | $1,657.11 | $306.88 | $1,146.72 | $2,479.03 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 13 | $6,134.54 | $1,533.63 | $347 | $1,061.28 | $2,294.32 |
| CT abdomen without contrast | CPT | 74150 | 9 | $1,270.66 | $317.66 | $134.46 | $226.18 | $475.23 |
| CT abdomen with contrast | CPT | 74160 | 9 | $2,430.66 | $607.66 | $207 | $432.66 | $909.07 |
| CT abdomen with and without contrast | CPT | 74170 | 9 | $2,833.34 | $708.33 | $207 | $504.33 | $1,059.67 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 9 | $5,827.2 | $1,456.8 | $207 | $1,037.24 | $2,179.37 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 9 | $9,000 | $2,250 | $207 | $1,602 | $3,366 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 9 | $9,450 | $2,362.5 | $207 | $1,682.1 | $3,534.3 |
| MRI abdomen without contrast | CPT | 74181 | 10 | $2,196.29 | $549.07 | $306.88 | $368.97 | $821.41 |
| MRI abdomen with and without contrast | CPT | 74183 | 10 | $3,440.45 | $860.11 | $347 | $537.29 | $1,286.73 |
| Abdominal ultrasound complete | CPT | 76700 | 9 | $1,369.44 | $342.36 | $134.46 | $479.3 | $621.73 |
| Abdominal ultrasound limited | CPT | 76705 | 9 | $1,790.56 | $447.64 | $134.46 | $565.82 | $812.91 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 9 | $389.4 | $97.35 | $123.05 | $136.29 | $176.79 |
| Obstetric ultrasound first trimester | CPT | 76801 | 9 | $2,941.78 | $735.44 | $134.46 | $1,029.62 | $1,335.57 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 9 | $909.04 | $227.26 | $134.46 | $318.16 | $412.7 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 9 | $546.84 | $136.71 | $172.8 | $204.52 | $306.88 |
| Transvaginal ultrasound | CPT | 76830 | 9 | $1,615.79 | $403.95 | $134.46 | $565.53 | $733.57 |
| Pelvic ultrasound complete | CPT | 76856 | 9 | $2,311.24 | $577.81 | $134.46 | $808.93 | $1,049.3 |
| Scrotal ultrasound | CPT | 76870 | 9 | $2,155.26 | $538.81 | $134.46 | $754.34 | $978.49 |
| Diagnostic mammography unilateral | CPT | 77065 | 10 | $671.99 | $168 | $102.85 | $235.2 | $305.08 |
| Diagnostic mammography bilateral | CPT | 77066 | 10 | $897.82 | $224.45 | $131.79 | $314.24 | $407.61 |
| Screening mammography bilateral | CPT | 77067 | 10 | $723.47 | $180.87 | $108.84 | $253.21 | $328.46 |
| EKG tracing only | CPT | 93005 | 9 | $414.41 | $103.6 | $75.87 | $145.04 | $188.14 |
| Transthoracic echocardiogram complete | CPT | 93306 | 9 | $1,842.06 | $460.51 | $495.13 | $644.72 | $1,008.25 |
| Transthoracic echocardiogram | CPT | 93307 | 9 | $2,265.07 | $566.27 | $715.76 | $847.14 | $1,028.34 |
| Stress echocardiogram | CPT | 93350 | 9 | $9,176.87 | $2,294.22 | $702.78 | $2,501.27 | $4,166.3 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 7 | $90,850 | $22,713 | $21,550 | $37,478 | $64,517 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 7 | $66,094 | $16,523 | $11,306 | $18,828 | $32,412 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 7 | $57,865 | $14,466 | $7,969.35 | $12,755 | $21,957 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 7 | $58,890 | $14,722 | $16,961 | $29,123 | $50,135 |
| COPD w MCC | MS-DRG | 190 | 7 | $49,354 | $12,339 | $12,303 | $18,981 | $28,624 |
| COPD w CC | MS-DRG | 191 | 7 | $37,605 | $9,401.23 | $9,592.96 | $14,445 | $21,784 |
| COPD w/o CC/MCC | MS-DRG | 192 | 7 | $35,624 | $8,906.06 | $7,535.29 | $11,001 | $16,590 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 7 | $40,555 | $10,139 | $9,213.14 | $13,323 | $20,825 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 7 | $26,064 | $6,516.07 | $7,397.09 | $10,390 | $16,241 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | $53,186 | $13,297 | $17,384 | $29,435 | $51,463 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | $46,111 | $11,528 | $10,372 | $16,865 | $29,487 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | $35,762 | $8,940.56 | $8,365.52 | $13,269 | $23,198 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | $44,649 | $11,162 | $14,105 | $23,558 | $41,187 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | $34,861 | $8,715.2 | $9,654.39 | $15,579 | $27,238 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | $26,271 | $6,567.67 | $6,757.26 | $10,386 | $18,158 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | $55,759 | $13,940 | $11,997 | $13,289 | $38,627 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | $38,606 | $9,651.6 | $8,494.51 | $10,353 | $23,603 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | $32,951 | $8,237.69 | $5,596 | $6,758.29 | $18,162 |
| GI hemorrhage w CC | MS-DRG | 378 | 7 | $47,769 | $11,942 | $11,003 | $18,277 | $31,463 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 7 | $38,313 | $9,578.19 | $7,416.53 | $11,748 | $20,224 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 7 | $39,963 | $9,990.71 | $8,943.92 | $14,529 | $25,011 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | $26,520 | $6,629.9 | $17,012 | $29,216 | $50,295 |
| Kidney/UTI w MCC | MS-DRG | 689 | 8 | $46,940 | $11,735 | $12,841 | $21,624 | $38,828 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 8 | $36,846 | $9,211.43 | $9,250.02 | $15,086 | $27,089 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 8 | $70,190 | $17,548 | $20,849 | $36,201 | $65,004 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 8 | $46,283 | $11,571 | $11,439 | $19,071 | $34,244 |
| Initial hospital care, low complexity | CPT | 99221 | 6 | $124.03 | $31.01 | $39.19 | $43.41 | $56.31 |
| Initial hospital care, moderate complexity | CPT | 99222 | 6 | $924.53 | $231.13 | $210.23 | $297.1 | $419.74 |
| Initial hospital care, high complexity | CPT | 99223 | 6 | $660.82 | $165.2 | $149.7 | $211.95 | $300.01 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 9 | $244 | $61 | $8.46 | $84.42 | $110.78 |
| General health panel | CPT | 80050 | 6 | $454.46 | $113.61 | $152.7 | $159.06 | $206.32 |
| Electrolyte panel | CPT | 80051 | 9 | $69.98 | $17.49 | $7.01 | $24.21 | $31.77 |
| Comprehensive metabolic panel | CPT | 80053 | 9 | $391.99 | $98 | $10.56 | $135.63 | $177.96 |
| Renal function panel | CPT | 80069 | 9 | $88 | $22 | $8.68 | $30.45 | $39.95 |
| Hepatic function panel | CPT | 80076 | 9 | $284.84 | $71.21 | $8.17 | $98.55 | $129.32 |
| Urinalysis non-automated | CPT | 81002 | 9 | $21.09 | $5.27 | $3.48 | $7.09 | $9.57 |
| Urinalysis automated | CPT | 81003 | 9 | $84.77 | $21.19 | $2.25 | $24.32 | $38.49 |
| Glucose quantitative | CPT | 82947 | 9 | $23.04 | $5.76 | $3.93 | $7.97 | $10.46 |
| Hemoglobin A1c | CPT | 83036 | 11 | $51.84 | $12.96 | $9.71 | $17.68 | $23.54 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 9 | $134.32 | $33.58 | $16.8 | $46.47 | $60.98 |
| Complete blood count with automated differential | CPT | 85025 | 10 | $110 | $27.5 | $7.77 | $38.06 | $49.94 |
| Complete blood count without differential | CPT | 85027 | 10 | $151.63 | $37.91 | $6.47 | $52.46 | $68.84 |
| Tissue exam by pathologist level IV | CPT | 88305 | 9 | $254.59 | $63.65 | $64.1 | $71.35 | $115.58 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 11 | $617.4 | $154.35 | $195.1 | $280.3 | $529.11 |
| Vaginal delivery only | CPT | 59409 | 14 | $17,578 | $4,394.45 | $4,163.48 | $14,343 | $15,679 |
| office | ||||||||
| Office visit, established patient, 5 min | CPT | 99211 | 9 | $264.6 | $66.15 | $50.32 | $92.61 | $765.95 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 9 | $242.11 | $60.53 | $34.84 | $59.8 | $171.24 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 9 | $293.71 | $73.43 | $66.67 | $73.43 | $171.24 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | $2,901.6 | $725.4 | $522.29 | $731.2 | $2,486.67 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | $2,597.4 | $649.35 | $436.36 | $1,677.92 | $2,316.88 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | $2,121.65 | $530.41 | $356.44 | $428.57 | $1,196.08 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | $1,982.3 | $495.57 | $449.98 | $495.58 | $1,196.08 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | $2,997.98 | $749.49 | $251.83 | $503.66 | $1,196.08 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | $3,887.4 | $971.85 | $653.08 | $960.19 | $1,539.08 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | $3,385.34 | $846.33 | $768.47 | $846.34 | $1,539.08 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 11 | $17,960 | $4,490 | $3,017.28 | $3,107.08 | $22,551 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 6 | $17,253 | $4,313.25 | $2,898.5 | $2,933.01 | $6,452.62 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | $13,184 | $3,296.03 | $2,214.94 | $2,346.78 | $9,332.7 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 9 | $11,856 | $2,963.99 | $1,991.8 | $2,110.36 | $4,434.13 |
| ACL reconstruction | CPT | 29888 | 10 | $19,333 | $4,833.36 | $3,248.02 | $3,441.35 | $9,332.7 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | $316,946 | $79,236 | $48,018 | $76,964 | $118,778 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | $332,409 | $83,102 | $25,504 | $40,139 | $61,946 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | $332,038 | $83,010 | $18,191 | $28,178 | $43,488 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 7 | $157,036 | $39,259 | $18,280 | $26,572 | $43,713 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 7 | $131,792 | $32,948 | $14,945 | $21,454 | $35,294 |
| Laparoscopic appendectomy | CPT | 44970 | 13 | $55,689 | $13,922 | $7,775.56 | $38,836 | $42,767 |
| Major joint replacement w MCC | MS-DRG | 469 | 7 | $175,818 | $43,954 | $32,014 | $40,580 | $69,603 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 7 | $174,146 | $43,536 | $20,709 | $25,193 | $44,262 |
| Laparoscopic cholecystectomy | CPT | 47562 | 11 | $49,755 | $12,439 | $7,775.56 | $8,607.53 | $18,608 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 9 | $50,252 | $12,563 | $7,775.56 | $8,542.89 | $18,794 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 7 | $158,061 | $39,515 | $30,777 | $54,275 | $93,432 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 7 | $152,766 | $38,191 | $22,405 | $39,034 | $67,196 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 7 | $132,628 | $33,157 | $17,660 | $30,396 | $52,326 |
| Lap inguinal hernia repair | CPT | 49650 | 10 | $16,417 | $4,104.36 | $1,838.75 | $2,758.13 | $7,775.56 |
| Vaginal hysterectomy | CPT | 58260 | 12 | $19,493 | $4,873.34 | $3,274.89 | $3,421.09 | $7,290.52 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 9 | $56,560 | $14,140 | $9,502.01 | $10,068 | $21,153 |
| Lap salpingo-oophorectomy | CPT | 58661 | 10 | $57,124 | $14,281 | $7,775.56 | $9,711.11 | $21,364 |
| Complex cataract surgery | CPT | 66982 | 11 | $7,446.85 | $1,861.71 | $1,251.07 | $1,288.31 | $2,968.25 |
| Cataract surgery with lens implant | CPT | 66984 | 9 | $7,774.02 | $1,943.5 | $1,306.04 | $1,383.78 | $2,968.25 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 8 | $125,770 | $31,442 | $13,664 | $22,767 | $41,519 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 8 | $83,892 | $20,973 | $21,940 | $38,188 | $68,571 |
Payer mix (top 15)
| Payer | Codes covered | Median rate |
|---|---|---|
| uh [819] | 149 | $737.45 |
| veba med grp [813] | 149 | $817.08 |
| Cigna | 149 | $492.38 |
| hn [815] | 149 | $720.19 |
| scan [500] | 144 | $448.71 |
| la care mcr adv hmo [612] | 144 | $448.71 |
| Medicare Advantage | 144 | $448.71 |
| UnitedHealthcare | 117 | $572.92 |
| Kaiser Permanente | 110 | $823.57 |
| alignment health plan [443] | 30 | $462.17 |
| ucsd [807] | 25 | $1,245.13 |
| Blue Cross Blue Shield | 17 | $1,273.86 |
| managed health network [862] | 11 | $4,703.55 |
| managed health network [620] | 11 | $4,703.55 |
| optum health mcr adv [491] | 4 | $2,306.1 |