CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Florida Sarasota Doctors Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,705
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Florida Sarasota Doctors Hospital is $26,705. 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 1.14x the Medicare baseline. Located in 5731 Bee Ridge Rd, Sarasota, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,705

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: $26,705 (114%)
Ins. Median: $26,705 (114% 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
Sunshine State Health Plan $2,381 - $11,906 10%
Cigna $2,999 - $73,556 13%
Humana $3,817 - $25,648 16%
Avmed $3,998 - $79,119 17%
United $4,000 - $71,125 17%
Molina $11,098 - $28,027 47%
Aetna $11,377 - $26,705 48%
Wellmed $25,912 110%
Access 2 Healthcare Physicians Freedom Optimum Group Members $26,441 112%
Behealthy America $26,441 112%
Ultimate Health Plan $26,441 112%
United Behavioral Health $26,441 112%
United Va Ccn $26,441 112%
Access 2 Healthcare Physicians Freedom Health $26,705 114%
Access 2 Healthcare Physicians Optimum $26,705 114%
Blue Cross Blue Shield $26,705 - $80,378 114%
Freedom Health Care $26,705 114%
Optimum Healthcare $26,705 114%
Clear Spring Health $27,763 118%
Simply Healthcare $27,763 - $148,252 118%
American Health Plan $28,027 119%
Secur $28,556 121%
Align Senior Care $28,821 123%
Florida Complete Care $28,821 123%
Gold Kidney Of Florida $28,821 123%
Centurion $29,085 124%
Sunshine State $31,333 133%
Wellcare $31,333 133%
Ndms Definitive Care $33,051 141%
Oscar $34,094 145%
Evolutions Healthcare Systems $36,988 157%
Truli $60,256 - $76,915 256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5731 Bee Ridge Rd, Sarasota, FL 34233
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals