CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Wellstar McG Health, Affiliated With Med Col

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $34,189
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Wellstar McG Health, Affiliated With Med Col is $34,189. 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 1.45x the Medicare baseline. Located in 1120 15Th Street, Augusta, GA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$34,189

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: $34,189 (145%)

Ins. Median: $34,189 (145% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
The Care Network	$27,818	118%
Aetna	$31,917 - $85,541	136%
UnitedHealthcare	$31,917 - $66,592	136%
Blue Cross Blue Shield	$32,556 - $83,886	139%
Humana	$32,556	139%
Select Health	$33,194	141%
Absolute Total Care	$33,513	143%
Cigna	$33,513 - $123,753	143%
Clear Spring	$33,513	143%
Georgia Health	$33,513	143%
Molina	$33,513	143%
Wellcare	$33,513	143%
Clover	$34,151	145%
Devoted Health Plan	$34,151	145%
Pruitt Health	$34,151	145%
Industry Buying Group	$34,226	146%
Molina Marketplace	$36,705	156%
Centurion	$41,492	177%
Oscar Healthplan	$54,259	231%
Peachstate	$59,047	251%
Caresource	$62,558	266%
Naphcare	$79,793	339%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Wellstar McG Health, Affiliated With Med Col is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.