CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Baxter Health

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $21,416
Cash Discount Price: $19,466
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Baxter Health is $21,416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19,466. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 0.91x the Medicare baseline. Located in 624 Hospital Drive, Mountain Home, AR.

Cash / Self-Pay

$19,466

Average discount available for prompt cash payment at this facility.

Insurance Median

$21,416

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$23,503.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $23,503.93 (100%)

Cash / Self-Pay: $19,466 (83%)

Insurance Median: $21,416 (91%)

Cash: $19,466 (83% of Medicare)

Ins. Median: $21,416 (91% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

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

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Cigna	$3,450	15%
Web Tpa	$3,450	15%
Aetna	$21,416	91%
Humana	$21,416 - $22,487	91%
Non Contracted	$21,416	91%
Tricare	$21,416	91%
UnitedHealthcare	$21,416 - $32,924	91%
Va	$21,416	91%
Allwell	$22,058	94%
Blue Cross Blue Shield	$22,701 - $31,577	97%
Ambetter / Centene	$31,053	132%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $19,466.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Baxter Health is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.