CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: HCA Florida Poinciana Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $28,756
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at HCA Florida Poinciana Hospital is $28,756. 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 1.22x the Medicare baseline. Located in 325 Cypress Pkwy, Kissimmee, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$28,756

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: $28,756 (122%)
Ins. Median: $28,756 (122% 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%
Humana $3,887 - $28,756 17%
United $4,222 - $76,677 18%
Molina Healthcare $11,098 - $29,030 47%
Sunshine State Health Plan $11,736 50%
Wellmed $26,839 114%
Blue Cross Blue Shield $27,661 - $83,480 118%
Clear Spring Health $27,934 119%
Devoted Health $27,934 119%
Fl Health Care Plan $27,934 119%
Ultimate Health Plan $27,934 119%
Aetna $28,071 - $47,419 119%
Freedom Health $28,482 121%
Optimum $28,482 121%
Align Senior Care $28,756 122%
Florida Complete Care $28,756 122%
American Health Plan $29,030 124%
Careplus $29,030 - $31,495 124%
Simply $29,304 125%
Solis Health Plan $29,304 125%
Longevity Health Plan $29,578 126%
Gold Kidney Of Florida $29,852 127%
Centurion $30,125 128%
Sunshine State $30,262 129%
Wellcare $30,262 129%
Ndms Definitive Care $34,233 146%
Oscar $43,843 187%
Truli For Health $50,718 216%
Evolutions $52,355 223%
Simply Healthcare $162,943 693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Cypress Pkwy, Kissimmee, FL 34758
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals