CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $36,014
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Atrium Health Navicent the Medical Center is $36,014. 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 1.53x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$36,014

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: $36,014 (153%)
Ins. Median: $36,014 (153% 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 $26,466 - $43,806 113%
Blue Cross Blue Shield $26,466 - $43,404 113%
Georgia Health Advantage $26,466 113%
Humana $26,466 - $60,157 113%
Pruitt Health $26,466 113%
UnitedHealthcare $26,466 - $70,867 113%
Care Source $26,996 115%
Clover $26,996 115%
Eon Health $26,996 115%
Alliant $27,904 119%
Cigna $36,014 153%
Securehealth $42,932 183%
Kaiser $53,795 229%
Ibg $63,121 269%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hemlock Street, Macon, GA 31201
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals