CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Florida Jfk Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $28,250
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Florida Jfk Hospital is $28,250. 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 1.20x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$28,250

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: $28,250 (120%)
Ins. Median: $28,250 (120% 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
Humana $2,497 - $27,696 11%
Avmed $2,797 - $70,676 12%
Medica Healthcare $3,750 16%
United $4,000 - $64,171 17%
Molina $11,098 - $29,912 47%
Sunshine State Health Plan $13,561 58%
Oscar $26,308 - $28,804 112%
Palm Beach Pace $26,312 112%
Wellmed $26,866 114%
Careplus Sfl $27,696 118%
United Behavioral Health $27,696 118%
Veterans Evaluation Services $27,696 118%
Blue Cross Blue Shield $27,973 - $52,328 119%
Cigna $28,250 - $37,976 120%
Devoted Health $28,250 120%
Mmm Of Fl (Health Advantage Plan) $28,250 120%
Aetna $28,389 - $49,413 121%
Amerihealth Caritas $28,527 - $77,175 121%
Sunshine State $28,527 - $30,466 121%
Health Sun Health Plan $28,804 123%
Longevity Health Plan $28,804 123%
Prominence Healthfirst $28,804 123%
Align $29,358 125%
American Health Plan $29,358 125%
Florida Complete Care $29,358 125%
Freedom Health $29,358 125%
Optimum $29,358 125%
Simply Healthcare Plans $29,912 127%
Aids Healthcare $30,189 128%
Doctors Healthcare Plan $30,189 128%
Centurion $30,466 130%
Gold Kidney $31,020 132%
Solis Health Plan $31,020 132%
Ndms Definitive Care $34,621 147%
Simply Healthcare $133,560 568%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5301 S Congress Ave, Atlantis, FL 33462
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals