CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Wellstar West Georgia Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $36,770
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Wellstar West Georgia Medical Center is $36,770. 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 1.56x the Medicare baseline. Located in 1514 Vernon Road, Lagrange, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$36,770

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: $36,770 (156%)
Ins. Median: $36,770 (156% 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
Aetna $26,549 - $85,541 113%
Cigna $26,549 - $123,753 113%
Blue Cross Blue Shield $27,080 - $108,271 115%
Humana $27,080 115%
UnitedHealthcare $27,080 - $86,547 115%
Clear Spring $27,876 119%
Wellcare $27,876 119%
Clover $28,407 121%
Pruitt $28,407 121%
Sonder $28,407 121%
Oscar Healthplan $45,133 192%
Ambetter / Centene $46,725 199%
Peachstate $49,115 209%
Caresource $52,035 221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1514 Vernon Road, Lagrange, GA 30240
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals