CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Banner Gateway Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,580
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Banner Gateway Medical Center is $27,580. 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 1.17x the Medicare baseline. Located in 1900 North Higley Road, Gilbert, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,580

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: $27,580 (117%)
Ins. Median: $27,580 (117% 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 $27,580 - $82,112 117%
Arizona Physicians Ipa $27,580 117%
Banner Health $27,580 117%
Banner University Health Plan $27,580 117%
Blue Cross Blue Shield $27,580 117%
Care 1St $27,580 117%
Cigna $27,580 - $93,398 117%
Gila River Health Care Corporation $27,580 117%
Health Choice Arizona, Inc. $27,580 - $41,370 117%
Health Net $27,580 - $40,819 117%
Humana $27,580 - $28,408 117%
Kaiser Foundation Health Plan $27,580 117%
Mercy Care $27,580 117%
Triwest Healthcare Alliance Corp - Va Ccn $27,580 117%
UnitedHealthcare $27,580 - $81,835 117%
Upmc Health Plan $27,580 117%
Wellpoint (Fka Amerigroup) $27,580 117%
Carekin $28,959 123%
Devoted Health Services $28,959 123%
Arizona Priority Care $30,338 129%
Gold Kidney Health Plan $30,338 129%
Oscar Health Plan $45,507 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 North Higley Road, Gilbert, AZ 85234
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals