CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $29,035
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Central Florida Lake Monroe Hospital is $29,035. 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 1.24x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$29,035

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: $29,035 (124%)
Ins. Median: $29,035 (124% 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
Cigna $2,834 - $78,483 12%
Avmed $2,968 - $79,119 13%
United $4,222 - $76,677 18%
Humana $8,698 - $31,227 37%
Sunshine State Health Plan $11,736 50%
Molina Healthcare $13,318 - $29,035 57%
Wellmed $26,844 114%
Blue Cross Blue Shield $27,666 - $81,784 118%
Fl Health Care Plan $27,666 118%
Devoted Health $27,940 119%
Ultimate Health Plan $27,940 119%
Aetna $28,077 - $47,419 119%
Clear Spring Health $28,214 120%
Freedom Health $28,488 121%
Optimum $28,488 121%
Simply $28,761 122%
American Health Plan $29,035 124%
Solis Health Plan $29,309 125%
Sunshine State $29,446 125%
Wellcare $29,446 125%
Longevity Health Plan $29,583 126%
Careplus $29,857 - $31,501 127%
Gold Kidney Of Florida $29,857 127%
Align Senior Care $30,131 128%
Centurion $30,131 128%
Florida Complete Care $30,131 128%
Seminole County Sheriffs Office $30,131 128%
Ndms Definitive Care $34,240 146%
Oscar $43,843 187%
Truli For Health $50,463 215%
Florida Health Care Plan $51,764 220%
Evolutions $52,355 223%
Simply Healthcare $162,943 693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals