CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Florida Capital Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $28,795
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Florida Capital Hospital is $28,795. 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 1.23x the Medicare baseline. Located in 2626 Capital Medical Blvd, Tallahassee, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$28,795

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: $28,795 (123%)
Ins. Median: $28,795 (123% 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 $4,741 - $28,795 20%
United $5,314 - $70,346 23%
Sunshine State Health Plan $11,680 50%
Molina Healthcare $13,318 - $28,795 57%
Wellmed $26,622 113%
United Behavioral Health $27,165 116%
Blue Cross Blue Shield $27,437 - $71,014 117%
Ultimate Health Plan $27,708 118%
Aetna $27,844 - $47,158 118%
Simply $28,523 121%
American Health Plan $28,795 123%
Sunshine State $29,203 124%
Wellcare $29,203 124%
Gold Kidney Of Florida $29,610 126%
Align Senior Care $29,882 127%
Centurion $29,882 127%
Florida Complete Care $29,882 127%
Longevity Health Plan $29,882 127%
Gadsden County Jail $33,956 144%
Ndms Definitive Care $33,956 144%
Physician Network Association $35,315 150%
Oscar $40,228 171%
Naphcare $43,464 185%
Simply Healthcare $162,943 693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2626 Capital Medical Blvd, Tallahassee, FL 32308
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals