CMS Price Transparency Data
Spinal fusion, single level (inpatient stay)
Facility: Clovis Community Medical Center
Billing Code: 451 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 451
- Insurance Median: $31,498
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Clovis Community Medical Center is $31,498. 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 1.34x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$31,498
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: $31,498 (134%)
Ins. Median: $31,498 (134% 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 |
|---|---|---|
| Advantek Table Mountain Rancheria Tribal Member | $31,498 | 134% |
| Aetna | $31,498 - $38,718 | 134% |
| Blue Cross Blue Shield | $31,498 | 134% |
| Blue Shield | $31,498 | 134% |
| Blue Shield 65 Plus Hmo Ehs | $31,498 | 134% |
| Blue Shield 65 Plus Hmo First Choice | $31,498 | 134% |
| Blue Shield Hmo-Cvmp/Medpro | $31,498 | 134% |
| Blue Shield Promise - Imperial | $31,498 | 134% |
| Blue Shield Saint Agnes | $31,498 | 134% |
| Blue Shield Sante | $31,498 | 134% |
| Brand New Day | $31,498 | 134% |
| Bscphp - Dhmso | $31,498 | 134% |
| Bscphp - First Choice | $31,498 | 134% |
| Bscphp Hmo - First Choice | $31,498 | 134% |
| Care1St Hmo - Ehs | $31,498 | 134% |
| Cares Act Provider Relief Fund | $31,498 | 134% |
| Cigna | $31,498 | 134% |
| Gemcare Hmo | $31,498 | 134% |
| Generic | $31,498 | 134% |
| Generic Bscphp | $31,498 | 134% |
| Generic Victims Of Crime | $31,498 | 134% |
| Hartford Life Supplement | $31,498 | 134% |
| Healthnet Hmo - Cvmp/Medpro | $31,498 | 134% |
| Healthnet Hmo - Dhmso | $31,498 | 134% |
| Healthnet Hmo - La Salle | $31,498 | 134% |
| Healthnet Hmo - Sante | $31,498 | 134% |
| Healthnet Sante | $31,498 | 134% |
| Healthnet Sante - Sub Cap Dual Risk | $31,498 | 134% |
| Healthnet Sante Dual Risk | $31,498 | 134% |
| Humana | $31,498 | 134% |
| Medi-Cal Innovative Integrated Health | $31,498 | 134% |
| Medicare (plans) | $31,498 | 134% |
| Meritage Blue Shield 65 Plus | $31,498 | 134% |
| Meritage Brand New Day | $31,498 | 134% |
| Meritage Healthnet Hmo | $31,498 | 134% |
| Railroad Part A | $31,498 | 134% |
| Railroad Part A & B | $31,498 | 134% |
| Railroad Part B | $31,498 | 134% |
| Sante Sub Cap Healthnet Seniority | $31,498 | 134% |
| Sante Sub Cap-Blue Shield/Sante | $31,498 | 134% |
| Sante-Blue Shield/Sante | $31,498 | 134% |
| Sante-Healthnet Seniority | $31,498 | 134% |
| Sante-Sub Cap Ma Brand New Day | $31,498 | 134% |
| Scan Health Plan | $31,498 | 134% |
| Sequoia Pace - Peak Tpa | $31,498 | 134% |
| Todays Pyramid | $31,498 | 134% |
| UnitedHealthcare | $31,498 - $31,970 | 134% |
| Us Marshal | $31,498 | 134% |
| Victims Of Crime | $31,498 | 134% |
| Wellcare | $31,498 | 134% |
| Alignment Health Plan | $34,648 | 147% |
| Champion Health Plan Of California Ma | $34,648 | 147% |
| Innovative Integrated Health Community Plans Hmo | $34,648 | 147% |
| Imperial Health Plan Hmo | $36,222 | 154% |
| Kaiser | $36,874 | 157% |
| Correctcare Integrated Health | $40,947 | 174% |
| Coalinga State Hospital | $62,995 | 268% |
| Naphcare Inc-Mendota | $67,720 | 288% |