CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Providence St. Joseph Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $32,884
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Providence St. Joseph Hospital is $32,884. 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 1.40x the Medicare baseline. Located in 1100 West Stewart Dr, Orange, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$32,884

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: $32,884 (140%)
Ins. Median: $32,884 (140% 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 $32,884 140%
Beacon Health $32,884 140%
Blue Cross Blue Shield $32,884 - $42,115 140%
Blue Shield $32,884 140%
Brand New Day $32,884 140%
Caremore $32,884 140%
Central Health Plan $32,884 140%
Cigna $32,884 - $70,639 140%
Healthcare Partners $32,884 140%
Healthnet $32,884 - $79,817 140%
Heritage Provider Network $32,884 140%
Humana $32,884 140%
Inland Empire Health Plan $32,884 140%
Kaiser $32,884 140%
La Care $32,884 140%
Managed Health Network $32,884 140%
Molina $32,884 140%
Monarch Health Plan $32,884 - $48,756 140%
Onecare $32,884 140%
Providence Health Plan $32,884 140%
UnitedHealthcare $32,884 - $82,017 140%
Providence $37,529 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 West Stewart Dr, Orange, CA 92868
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals