Spinal fusion, single level (inpatient stay)
Facility: Scott County Hospital
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $6,716
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.29x 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 | $12,231 | 52% |
Consumer Guidance & Cost Commentary
For a spinal fusion at Scott County Hospital in Scott City, Kansas, the negotiated rate of $6,716.00 is significantly lower than the state average, which stands at 30% higher than the Medicare benchmark of $23,503.93. This facility, a critical access hospital, offers a transparent pricing structure where the negotiated amount aligns closely with the low end of the UnitedHealthcare payment range. While cash payments are not currently listed in the data, patients with high-deductible plans should be aware that paying out-of-pocket can sometimes be more cost-effective if the insurance negotiated rate exceeds the cash price. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final amount owed.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Avoid accepting summary bills that obscure individual charges, and instead demand a detailed statement showing specific CPT codes to identify any discrepancies. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should verify your deductible status before scheduling to avoid unexpected costs. By comparing this facility's rates against the Medicare benchmark and seeking a full itemized breakdown, you can make informed decisions that protect your financial well-being.