Spinal fusion, single level (inpatient stay)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $21,102
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Blue Cross Blue Shield | $19,459 - $21,102 | 83% |
| Humana | $20,680 | 88% |
| United Mine Workers Of America | $21,102 | 90% |
| Aetna | $21,102 - $28,066 | 90% |
| UnitedHealthcare | $21,102 | 90% |
| Providrs Care Network | $21,102 | 90% |
| Lantern Specialty Care | $33,764 | 144% |
Consumer Guidance & Cost Commentary
For the Spinal fusion, single level procedure at Kansas Spine & Specialty Hospital in Wichita, the negotiated rates range from $19,459 to $28,066 across seven payers, with a median negotiated amount of $21,102. This facility is owned by a physician and operates as an acute care hospital in Kansas. While specific cash and median paid values are not available in this dataset, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can offer significant fee reductions for upfront payment.
The Medicare benchmark for this service is $23,503.93, which serves as the objective baseline for evaluating pricing markups. Commercial negotiated rates often average between 200% and 300% of Medicare, though fair pricing is typically defined as 120% to 150% of this amount. Since this report does not provide specific county or state average data for comparison, patients should focus on verifying their specific plan's allowed amount before scheduling to ensure they are not paying more than their insurer has contracted to pay. If you receive a bill, request a full itemized statement to review every code and unit cost, as over 80% of hospital bills contain errors such as double-billing or unbundled charges that can be corrected through a formal written audit dispute.