CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Marion Communtiy Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $29,542
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Marion Communtiy Hospital is $29,542. 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 1.26x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$29,542

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: $29,542 (126%)
Ins. Median: $29,542 (126% 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 $2,374 - $78,075 10%
Avmed $2,968 - $66,826 13%
Humana $4,954 - $32,074 21%
United $5,388 - $70,731 23%
Sunshine State Health Plan $11,680 50%
Molina Healthcare $13,318 - $29,823 57%
Wellmed $27,572 117%
Va Purchased Care Program $28,135 120%
Veterans Evaluation Services $28,135 120%
Blue Cross Blue Shield $28,416 - $65,436 121%
Sunshine State $28,557 121%
Wellcare $28,557 121%
Aetna $28,698 - $47,419 122%
Devoted Health $28,698 122%
Ultimate Health Plan $28,698 122%
Freedom Optimum $29,260 124%
Align Senior Care $29,542 126%
Florida Complete Care $29,542 126%
Longevity Health Plan $29,542 126%
Simply $29,542 126%
American Health Plan $29,823 127%
Careplus $29,823 - $32,355 127%
Secur $30,386 129%
Gold Kidney Of Florida $30,667 130%
Centurion $30,949 132%
Ndms Definitive Care $35,169 150%
Evolutions Healthcare $49,861 212%
Evolutions $52,355 223%
Naphcare $54,863 - $67,524 233%
University Ma Federal Corrections $54,863 - $67,524 233%
Wellpath $54,863 - $67,524 233%
Simply Healthcare $130,889 557%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals