CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Piedmont Walton Hospital

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$35,359

about 1.5× the $23,504 Medicare rate · typically $26,320–$54,418

modeled estimate · not a bill or quote

What this hospital charges insurers

$52,208

Above the fair price

about $16,849 over the fair price · 2.2× Medicare

Medicare pays $23,504 Fair price $35,359 This hospital $52,208 Cash price $55,549 Hospital's list price $185,162

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $12,060 Priciest $52,208

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $35,359 (about 1.5× the $23,504 Medicare rate). Piedmont Walton Hospital charges insurers about $52,208, or about $55,549 in cash — above the fair price. Located in Monroe, GA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $35,359. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$26,690 - $72,338	114%
Blue Cross Blue Shieldmajor	$75,924 - $76,362	323%
Aetnamajor	$48,046	204%
Cignamajor	$52,410 - $76,176	223%
Ambetter (Centene)	$46,901	200%
CareSource	$54,912	234%
+ 4 smaller / regional plans	$27,073 - $64,127

Government programs also on file: Medicare.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 55,549), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm Piedmont Walton Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Piedmont Walton Hospital

Compare: Spinal fusion, single level (inpatient stay) at other GA hospitals

Memorial Hospital and Manor · Bainbridge $12,060
Bacon County Hospital · Alma $21,342
Doctors Hospital · Augusta $23,936
Navicent Health Baldwin · Milledgeville $24,196
Memorial Health Meadows Hospital · Vidalia $24,236
Fairview Park Hospital · Dublin $24,376
Phoebe Putney Memorial Hospital · Albany $24,820
Phoebe Sumter Medical Center · Americus $25,162

Insurance negotiated median for the same procedure, sorted lowest first.