CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Banner Boswell Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $23,612
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Banner Boswell Medical Center is $23,612. 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 1.00x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$23,612

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: $23,612 (100%)
Ins. Median: $23,612 (100% 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.

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 $23,612 - $78,202 100%
Arizona Physicians Ipa $23,612 100%
Banner Health $23,612 100%
Banner University Health Plan $23,612 100%
Blue Cross Blue Shield $23,612 100%
Care 1St $23,612 100%
Cigna $23,612 - $93,398 100%
Gila River Health Care Corporation $23,612 100%
Health Choice Arizona, Inc. $23,612 - $35,418 100%
Health Net $23,612 - $34,946 100%
Humana $23,612 - $24,320 100%
Kaiser Foundation Health Plan $23,612 100%
Mercy Care $23,612 100%
Triwest Healthcare Alliance Corp - Va Ccn $23,612 100%
UnitedHealthcare $23,612 - $81,835 100%
Upmc Health Plan $23,612 100%
Wellpoint $23,612 100%
Carelon $24,792 105%
Devoted Health Services $24,792 105%
Arizona Priority Care $25,973 111%
Gold Kidney Health Plan $25,973 111%
Oscar Health Plan $38,960 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13632 N 99Th Ave, Sun City, AZ 85351
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals