CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Banner - University Medical Center Tucson Campus

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $32,627
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Banner - University Medical Center Tucson Campus is $32,627. 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 1.39x the Medicare baseline. Located in 1625 North Campbell Avenue, Tucson, AZ.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$32,627

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: $32,627 (139%)

Ins. Median: $32,627 (139% 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	$32,627 - $55,597	139%
Arizona Physicians Ipa	$32,627	139%
Banner Health	$32,627	139%
Banner University Health Plan	$32,627	139%
Blue Cross Blue Shield	$32,627	139%
Care 1St	$32,627	139%
Cigna	$32,627 - $56,440	139%
Gila River Health Care Corporation	$32,627	139%
Health Choice Arizona, Inc.	$32,627 - $48,941	139%
Health Net	$32,627 - $48,288	139%
Humana	$32,627 - $33,606	139%
Kaiser Foundation Health Plan	$32,627	139%
Mercy Care	$32,627	139%
Triwest Healthcare Alliance Corp - Va Ccn	$32,627	139%
UnitedHealthcare	$32,627 - $57,098	139%
Upmc Health Plan	$32,627	139%
Wellpoint	$32,627	139%
Carelon	$34,259	146%
Devoted Health Services	$34,259	146%
Arizona Priority Care	$35,890	153%
Gold Kidney Health Plan	$35,890	153%
Naphcare	$52,204	222%
Oscar Health Plan	$53,835	229%

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 Tucson Campus 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.