CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: The Women's Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $31,612
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at The Women's Hospital is $31,612. 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 1.34x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,612

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: $31,612 (134%)

Ins. Median: $31,612 (134% 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
Amish	$12,645	54%
Aetna	$23,933 - $31,312	102%
Humana	$23,933 - $31,612	102%
Passport Molina Ky	$23,933	102%
UnitedHealthcare	$23,933 - $49,734	102%
Wellcare Ky	$23,933 - $31,612	102%
Blue Cross Blue Shield	$31,612 - $50,252	134%
Caresource	$31,612	134%
Immergrun	$31,612	134%
Iu Health	$31,612	134%
Meridian Health Il	$31,612	134%
Mhs	$31,612	134%
Molina Il	$31,612	134%
Molina Ky	$31,612	134%
Molina Ky Dual	$31,612	134%
Alliance Coal	$37,468	159%
Claimdoc	$45,838	195%
Caresource Marketplace (Just4Me)	$47,418	202%
Hst	$47,418	202%
Encoreprime	$47,910	204%
Claritev (Formerly Phcs/Mulitplan)	$49,746	212%
Ambetter / Centene	$50,579	215%
Noncontracted	$50,579	215%
Hope Trust	$52,160	222%
One Care	$52,529	223%
Chamber Care	$52,699	224%
Cigna	$56,239	239%
Sagamore	$56,239	239%
Allied National/Zelis - Freedom Plan	$77,450	330%

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 The Women's 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.