CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Shands Jacksonville

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $38,232
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Shands Jacksonville is $38,232. 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 1.63x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$38,232

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: $38,232 (163%)
Ins. Median: $38,232 (163% 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
Capital Health Plan $13,829 59%
Health First Health Plan $17,606 - $18,413 75%
Truli For Health $25,233 107%
Blue Cross Blue Shield $28,038 - $49,494 119%
Aetna $33,296 - $35,286 142%
Ameri-Plus Preferred Care $37,143 158%
Humana $37,143 - $37,515 158%
Avmed $38,232 - $43,359 163%
Beacon Health Strategies $38,258 163%
Careplus Health Plan $38,258 163%
Florida Health Care Plan $38,258 - $51,363 163%
UnitedHealthcare $38,629 164%
Devoted Health Plan $39,000 - $40,858 166%
Florida Complete Care $40,858 174%
Positive Healthcare Partners $40,858 174%
Wellcare Of Florida $43,458 185%
Molina $44,433 189%
Cigna $47,036 200%
Volusia Health Network $54,686 233%
Wellpath $54,686 233%
Ambetter / Centene $56,737 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals