CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Piedmont Columbus Regional Northside

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $33,335
Cash Discount Price: $45,959
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Piedmont Columbus Regional Northside is $33,335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45,959. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.42x the Medicare baseline. Located in 100 Frist Court, Columbus, GA.

Cash / Self-Pay

$45,959

Average discount available for prompt cash payment at this facility.

Insurance Median

$33,335

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%)

Cash / Self-Pay: $45,959 (196%)

Insurance Median: $33,335 (142%)

Cash: $45,959 (196% of Medicare)

Ins. Median: $33,335 (142% 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
Phcs [10601]	$7,561	32%
Ambetter / Centene	$20,038	85%
Medicare (plans)	$20,640 - $21,441	88%
UnitedHealthcare	$20,940 - $94,315	89%
Clear Spring Health Care [30192]	$21,241	90%
Georgia Health Advantage [30143]	$21,441	91%
Cigna	$29,138 - $42,357	124%
Alliant Solocare [11101]	$40,802	174%
Caresource Marketplace [11106]	$43,082	183%
Blue Cross Blue Shield	$51,505 - $79,749	219%
Aetna	$60,780	259%
Alliant Health Plans Of Georgia [10952]	$64,127	273%

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 $45,959.
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 Piedmont Columbus Regional Northside 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.