Spinal fusion, single level (inpatient stay)
Facility: St. Catherine Hospital - Garden City
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $33,807
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.44x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $23,858 - $71,820 | 102% |
| Cigna | $24,104 - $128,721 | 103% |
| Humana | $24,104 - $33,807 | 103% |
| Kaiser | $24,104 - $35,017 | 103% |
| Innovage | $24,104 | 103% |
| Blue Cross Blue Shield | $24,104 - $36,761 | 103% |
| Devoted Health | $24,104 | 103% |
| Medicare (plans) | $24,104 - $33,807 | 103% |
| Aetna | $24,104 - $102,295 | 103% |
| Direct To Employer | $25,669 - $41,630 | 109% |
| Kansas Health | $33,807 | 144% |
| United Colorado Doctor'S Plan | $46,435 | 198% |
Consumer Guidance & Cost Commentary
For the Spinal fusion, single level procedure at St. Catherine Hospital in Garden City, KS, the Medicare benchmark rate is $23,503.93, which serves as the objective baseline for evaluating pricing fairness. While the facility's median negotiated rate across payers is $33,807, this figure represents the average amount commercial insurers agree to pay and often includes administrative overhead that inflates the baseline price by 20% to 40%. It is important to note that cash-pay options can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though the data provided does not list a specific cash median. Patients are encouraged to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing costly claims processing and administrative fees.
Pricing varies considerably by payer, with ranges spanning from a low of $23,858 for UnitedHealthcare to a high of $128,721 for Cigna, reflecting the complex dynamics of network tiering and contract negotiations. The No Surprises Act provides federal protection against balance billing for out-of-network services at in-network facilities, ensuring patients are not billed for the difference between a provider's chargemaster and their insurance allowed amount for emergency or non-emergency care. To ensure you are receiving fair pricing, it is recommended to request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. By comparing the facility's rates against the Medicare benchmark and actively seeking