CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Florida Highlands Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,490
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Florida Highlands Hospital is $26,490. 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 1.13x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,490

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: $26,490 (113%)
Ins. Median: $26,490 (113% 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
Avmed $3,251 - $70,676 14%
Cigna $4,535 - $38,592 19%
Humana $4,630 - $33,333 20%
United $6,000 - $47,315 26%
Wellmed $24,356 104%
Blue Cross Blue Shield $25,360 - $52,875 108%
Sunshine State $25,360 - $27,620 108%
Devoted Health $25,612 109%
Florida Complete Care $25,612 109%
Longevity Health Plan $25,612 109%
Aetna $25,737 - $54,353 110%
Freedom Health $26,114 111%
Prominence Healthfirst $26,114 111%
American Health Plan $26,616 113%
Molina $26,616 113%
Centurion $27,620 118%
Ndms Definitive Care $31,387 134%
Oscar $42,393 180%
Simply Healthcare $236,401 1006%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals