Spinal fusion, single level (inpatient stay)
Facility: Stormont Vail Hospital
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $23,052
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Ambetter / Centene | $13,688 - $26,984 | 58% |
| UnitedHealthcare | $13,688 - $26,984 | 58% |
| Blue Cross Blue Shield | $13,822 - $79,271 | 59% |
| Humana | $21,144 - $23,052 | 90% |
| Aetna | $21,144 - $23,052 | 90% |
Consumer Guidance & Cost Commentary
Stormont Vail Hospital in Topeka, KS, provides a spinal fusion, single level (inpatient stay) with a median negotiated rate of $23,052 and a Medicare amount of $23,503.93. While the facility operates as a voluntary non-profit private acute care hospital with a 4-star rating, specific cash or self-pay rates are not available in the current dataset. Patients should note that commercial insurance plans often result in higher out-of-pocket costs compared to cash pricing; for instance, Blue Cross Blue Shield offers a wide range from $13,822 to $79,271, whereas Humana and Aetna range between $21,144 and $23,052. Because the data does not include state or county average comparisons for this specific procedure, patients are advised to verify local market rates directly with the hospital before scheduling.
To minimize financial risk, consumers should inquire about "self-pay" or "prompt-pay" discounts before the procedure, as these upfront fee reductions can significantly lower the total cost for those without comprehensive insurance coverage. If a patient chooses to pay out-of-network, they must be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities, though they should still request an itemized billing audit to identify any unbundled codes or services not rendered. Since over 80% of hospital bills contain errors, patients should never accept a summary bill as the final invoice and should instead demand a detailed, line-by-line statement to dispute any inaccuracies via certified mail.