CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Banner - University Medical Center Phoenix

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $31,072
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Banner - University Medical Center Phoenix is $31,072. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.32x the Medicare baseline. Located in 1111 East McDowell Road, Phoenix, AZ.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,072

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%)

Insurance Median: $31,072 (132%)

Ins. Median: $31,072 (132% 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
Aetna	$29,593 - $78,202	126%
Arizona Physicians Ipa	$29,593	126%
Banner Health	$29,593	126%
Banner University Health Plan	$29,593	126%
Blue Cross Blue Shield	$29,593	126%
Care 1St	$29,593	126%
Gila River Health Care Corporation	$29,593	126%
Health Choice Arizona, Inc.	$29,593 - $44,389	126%
Health Net	$29,593 - $43,797	126%
Kaiser Foundation Health Plan	$29,593	126%
Mercy Care	$29,593	126%
Triwest Healthcare Alliance Corp - Va Ccn	$29,593	126%
UnitedHealthcare	$29,593 - $81,835	126%
Upmc Health Plan	$29,593	126%
Wellpoint	$29,593	126%
Humana	$30,481	130%
Carelon	$31,072	132%
Devoted Health Services	$31,072	132%
Arizona Priority Care	$32,552	138%
Gold Kidney Health Plan	$32,552	138%
Naphcare	$47,349	201%
Oscar Health Plan	$48,828	208%
Cigna	$84,060 - $93,398	358%

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 $X.
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 Banner - University Medical Center Phoenix 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.