CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Banner Heart Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $22,917
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Banner Heart Hospital is $22,917. 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 0.98x the Medicare baseline. Located in 6750 East Baywood Avenue, Mesa, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,917

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: $22,917 (98%)
Ins. Median: $22,917 (98% 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 $22,917 - $82,146 98%
Arizona Physicians Ipa $22,917 98%
Banner Health $22,917 98%
Banner University Health Plan $22,917 98%
Blue Cross Blue Shield $22,917 98%
Care 1St $22,917 98%
Cigna $22,917 - $93,398 98%
Gila River Health Care Corporation $22,917 98%
Health Choice Arizona, Inc. $22,917 - $34,375 98%
Health Net $22,917 - $33,917 98%
Humana $22,917 - $23,604 98%
Kaiser Foundation Health Plan $22,917 98%
Mercy Care $22,917 98%
Triwest Healthcare Alliance Corp - Va Ccn $22,917 98%
UnitedHealthcare $22,917 - $81,835 98%
Upmc Health Plan $22,917 98%
Wellpoint $22,917 98%
Carelon $24,063 102%
Devoted Health Services $24,063 102%
Arizona Priority Care $25,208 107%
Gold Kidney Health Plan $25,208 107%
Oscar Health Plan $37,813 161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6750 East Baywood Avenue, Mesa, AZ 85206
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals