Spinal fusion, single level (inpatient stay)
Facility: Overland Park Reg Med Ctr
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $24,607
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.05x 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 |
|---|---|---|
| United | $2,428 - $56,579 | 10% |
| Blue Cross Blue Shield | $3,692 - $48,534 | 16% |
| Humana | $4,466 - $24,607 | 19% |
| Multiplan | $6,522 | 28% |
| Amerigroup | $14,907 | 63% |
| Healthyblue | $15,205 | 65% |
| Unicare | $15,503 | 66% |
| Aetna | $15,503 - $62,557 | 66% |
| Coventry | $24,238 | 103% |
| Devoted Health | $25,099 | 107% |
| Celtic | $25,099 | 107% |
| Wellcare | $25,099 | 107% |
| Nhc Advantage | $25,345 | 108% |
| Cigna | $25,591 - $71,935 | 109% |
| Pyramid Life | $27,067 | 115% |
| Universal Healthcare | $27,314 | 116% |
| Oscar | $35,147 | 150% |
| Wppa Providrs Care Network | $50,000 | 213% |
| Ambetter / Centene | $51,439 | 219% |
Consumer Guidance & Cost Commentary
For the Spinal fusion, single level procedure at Overland Park Reg Med Ctr, the median negotiated rate paid by insurance is $61,701. This figure is significantly higher than the state average of $23,503.93, which is the Medicare benchmark for this service. While commercial insurance contracts often result in higher rates due to administrative costs and network dynamics, patients should be aware that cash-pay options can sometimes be more cost-effective, particularly for those with high-deductible plans where the insurance allowed amount exceeds the cash price. The facility offers a self-pay classification, and patients are encouraged to inquire directly about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the standard insurance billing cycle.
It is important to note that the data reflects negotiated rates for in-network payers, which can vary widely; for instance, United has a low-end rate of $2,428 while Aetna's range extends up to $62,557. Because commercial rates are often inflated by multi-layered contract structures, relying on the hospital's chargemaster list as a benchmark is misleading. To ensure you are not overcharged, request a full itemized bill before paying, as summary bills may obscure unbundled codes or services not rendered. If you receive a balance bill from an out-of-network provider, even at an in-network facility, you may have protections under the No Surprises Act, and you should dispute any unexpected charges in writing rather than accepting the initial invoice.