CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Holy Cross Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $41,026
Cash Discount Price: $89,787
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Holy Cross Hospital is $41,026. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89,787. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.75x the Medicare baseline. Located in 4725 N Federal Hwy, Ft Lauderdale, FL.

Cash / Self-Pay

$89,787

Average discount available for prompt cash payment at this facility.

Insurance Median

$41,026

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%)

Cash / Self-Pay: $89,787 (382%)

Insurance Median: $41,026 (175%)

Cash: $89,787 (382% of Medicare)

Ins. Median: $41,026 (175% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$23,633 - $41,026	101%
Medicare (plans)	$23,633 - $25,321	101%
Preferred Care Partners	$23,633	101%
Ryan White Florida Mssrp	$23,633	101%
UnitedHealthcare	$23,633 - $91,537	101%
Blue Cross Blue Shield	$24,115 - $80,424	103%
Vitas Healthcare Corp	$24,115	103%
Careplus Health Plans	$24,176	103%
Cigna	$24,342 - $43,533	104%
Solis Health Plans	$25,321	108%
General Electric	$26,400	112%
Molina Marketplace	$34,094	145%
Allied Benefit Systems	$41,026	175%
Coventry	$41,026	175%
Meritain	$41,026	175%
Ambetter / Centene	$42,405	180%
Mvp	$43,533	185%
Upmc Health Plan	$43,533	185%
Avmed Health Plan	$44,372 - $51,535	189%
Curative	$44,613	190%
Humana	$45,736	195%
Oscar	$47,039	200%
Centivo	$47,507	202%
Bcn Domestic	$52,614	224%
Blue Benefit Administrators Of Massachusetts	$52,614	224%
Blue Care Network	$52,614	224%
Blue Distinction Transplant	$52,614	224%
Blue Shield - Ca	$52,614	224%
Blue Shield - Id (Regence)	$52,614	224%
Blue Shield - Ny Highmark Northeastern	$52,614	224%
Blue Shield - Ny Highmark Western	$52,614	224%
Blue Shield - Pa (Highmark)	$52,614	224%
Blue Shield - Wa (Regence)	$52,614	224%
Health Choices	$52,614	224%
Kaiser Domestic	$52,614	224%
Pre-Employment	$52,614	224%
Wc Domestic	$52,614	224%
Geha	$64,350	274%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $89,787.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holy Cross Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.