Spinal fusion, single level (inpatient stay)
Facility: Select Specialty Hospital - Kansas City
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $1,700
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.07x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $23,503.93 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| No commercial in-network negotiated rate details found for this procedure. | ||
Consumer Guidance & Cost Commentary
For the procedure "Spinal fusion, single level (inpatient stay)" at Select Specialty Hospital - Kansas City, the facility's negotiated rate of $1,700.00 is significantly lower than the Medicare benchmark of $23,503.93, reflecting a 93% difference. This substantial gap highlights how commercial contracts can offer substantial savings compared to federal reimbursement standards, though it is important to note that these negotiated rates are often higher than actual cash prices due to administrative overhead and contract structures. While the data does not provide specific cash or median paid figures for this service, patients should be aware that paying out-of-pocket can sometimes result in lower costs if the insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans.
To maximize potential savings, consumers should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing costly insurance billing cycles. It is also critical to avoid balance billing by confirming the facility's network status and understanding that the No Surprises Act protects patients from unexpected out-of-network charges for emergency or non-emergency services at in-network facilities. Finally, before scheduling, patients should request an itemized bill to review specific CPT codes and ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that can be disputed in writing to reduce medical debt.