CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Riverside Community Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $39,470
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Riverside Community Hospital is $39,470. 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 1.68x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$39,470

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: $39,470 (168%)
Ins. Median: $39,470 (168% 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
Blue Shield $2,697 - $8,679 11%
Redlands Community $3,350 14%
First Health $3,407 14%
Health Net $4,472 - $8,580 19%
Cigna $5,314 - $143,871 23%
Aetna $6,944 - $39,470 30%
United $7,920 - $39,509 34%
Vitas Healthcare Hospice $27,629 118%
Bristol Hospice $31,576 134%
Brand New Day $38,680 - $59,205 165%
Alignment Health Plan $39,470 168%
Blue Cross Blue Shield $39,470 168%
Central Health Plan $39,470 168%
Clever Care Of Golden State $39,470 - $41,443 168%
Easy Choice Health Plan $39,470 168%
Heritage Provider Network $39,470 - $55,652 168%
Humana $39,470 168%
Medcare Partners $39,470 - $41,443 168%
Redlands Community Hospital $39,470 168%
Riverside Physician $39,470 168%
Scan Health Plan $39,470 168%
Triwest Healthcare Alliance $39,470 168%
UnitedHealthcare $39,470 168%
Care1St Health Plan $40,259 171%
Corvel Corporation $58,553 249%
Healthsmart $59,144 252%
Next $59,144 252%
Inland Empire Health Plan $71,045 302%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals