CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Terre Haute Regional Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $25,367
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Terre Haute Regional Hospital is $25,367. 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 1.08x the Medicare baseline. Located in 3901 S Seventh St, Terre Haute, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,367

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: $25,367 (108%)

Ins. Median: $25,367 (108% 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
United	$6,546 - $55,863	28%
Blue Cross Blue Shield	$24,630 - $45,602	105%
Humana	$24,630	105%
In State Health (Bccp)	$24,630	105%
Mdwise Hoosier Alliance	$24,630	105%
U.S. Penitentiary	$24,630	105%
United Behavioral Health	$24,630	105%
Corizon Health	$25,118	107%
Centurion	$25,616	109%
American Health Plans	$25,862	110%
Ambulatory Care Solutions	$30,788	131%
Molina	$33,251	141%
American Correctional	$40,640	173%
Naphcare	$40,640	173%
Cigna	$57,951 - $95,999	247%

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 Terre Haute Regional Hospital 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.