CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Norton-King's Daughters' Health

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $26,929
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Norton-King's Daughters' Health is $26,929. 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 1.15x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$26,929

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: $26,929 (115%)
Ins. Median: $26,929 (115% 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 $24,236 - $26,929 103%
Blue Cross Blue Shield $26,929 - $63,491 115%
Humana $26,929 115%
Managed Health Services Of Kentucky $26,929 115%
Passport By Molina $26,929 115%
UnitedHealthcare $26,929 115%
Managed Health Services $27,737 - $41,740 118%
Caresource Of Kentucky $37,701 160%
Caresource Of Indiana $40,394 172%
Custom Design Benefits $53,858 229%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals