Spinal fusion, single level (inpatient stay)
Facility: Wesley Medical Center
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $25,230
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.07x 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 |
|---|---|---|
| Aetna | $2,980 - $34,172 | 13% |
| United | $3,721 - $35,322 | 16% |
| UnitedHealthcare | $14,907 | 63% |
| Amerigroup | $15,503 | 66% |
| Medicaid / KanCare | $17,471 | 74% |
| Coventry Health Care | $25,230 | 107% |
| Humana | $25,230 | 107% |
| Devoted Health | $25,735 | 109% |
| Ambetter / Centene | $25,987 - $34,829 | 111% |
| Wppa | $35,222 - $50,317 | 150% |
| Blue Cross Blue Shield | $37,624 | 160% |
| Correct Care Solutions | $37,845 | 161% |
Consumer Guidance & Cost Commentary
For the procedure code 451, "Spinal fusion, single level (inpatient stay)," at Wesley Medical Center in Wichita, KS, the facility's negotiated rates range from $2,980 to $50,317 across 13 different payers, with a median negotiated amount of $25,230. This median rate is slightly higher than the state average of $25,230 but aligns closely with the national benchmark of 110% of the Medicare amount of $23,503.93. While commercial insurance contracts provide a ceiling on charges, they often result in higher out-of-pocket costs for patients who have not yet met their deductibles, as the administrative overhead and contract structures can inflate the baseline price by 20% to 40% compared to direct cash payments.
Patients should be aware that cash-pay options may offer significant savings, particularly for those with high-deductible plans where the insurance negotiated rate exceeds the cash price. Although the facility's cash median is not listed in this report, it is recommended to explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly claims processing. To ensure you receive the most accurate pricing, always verify the specific allowed amount with the hospital prior to your visit and avoid accepting summary bills; instead, demand a full itemized CPT-coded statement to identify any unbundled charges or services not rendered before finalizing payment.