CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Lucie Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $27,478
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at St Lucie Medical Center is $27,478. 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 1.17x the Medicare baseline. Located in 1800 Se Tiffany Ave, Port Saint Lucie, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$27,478

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: $27,478 (117%)
Ins. Median: $27,478 (117% 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
Avmed $3,251 - $70,676 14%
Cigna $4,535 - $38,592 19%
Humana $4,630 - $33,333 20%
United $6,000 - $53,603 26%
Molina $11,098 - $27,740 47%
Sunshine State Health Plan $11,652 50%
Vitas Healthcare $24,861 106%
Wellmed $25,385 108%
United Behavioral Health $26,170 111%
Veterans Evaluation Services $26,170 111%
Blue Cross Blue Shield $26,431 - $52,875 112%
Devoted Health $26,693 114%
Ultimate Health Plan $26,693 114%
Aetna $26,824 - $54,353 114%
Freedom Health $27,216 116%
Health Sun Health Plan $27,216 116%
Optimum $27,216 116%
Careplus $27,478 - $30,095 117%
American Health Plan $27,740 118%
Florida Complete Care $27,740 118%
Longevity Health Plan $27,740 118%
Sunshine State $28,002 - $28,787 119%
Simply Healthcare Plans $28,263 120%
Centurion $28,787 122%
Solis Health Plan $29,833 127%
Ndms Definitive Care $32,712 139%
Oscar $42,393 180%
Simply Healthcare $236,401 1006%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1800 Se Tiffany Ave, Port Saint Lucie, FL 34952
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals