Spinal fusion, single level (inpatient stay)
Facility: Kingman Healthcare Center
Billing Code: 451 (MS-DRG)
- CPT Billing Code: 451
- Insurance Median: $3,520
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.15x 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 |
|---|---|---|
| Celtic Insurance Company | $3,200 - $3,520 | 14% |
| Wellcare | $3,200 | 14% |
| UnitedHealthcare | $3,200 | 14% |
| Medicaid / KanCare | $3,200 - $12,779 | 14% |
| Humana | $3,200 | 14% |
| Ambetter / Centene | $3,520 | 15% |
| Healthy Blue | $12,779 | 54% |
Consumer Guidance & Cost Commentary
For the spinal fusion procedure at Kingman Healthcare Center in Kansas, the negotiated rates for in-network payers range from $3,200 to $3,520, with a median negotiated amount of $3,520. These contracted prices are significantly lower than the facility's Medicare benchmark of $23,503.93, reflecting the standard administrative markup inherent in commercial insurance contracts. While Medicaid/KanCare plans show a wide variance with a high-end rate of $12,779, most commercial carriers utilize a consistent $3,200 floor. Patients should be aware that cash-pay options are not listed for this service, but it is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can sometimes offer a lower total cost than the insurance negotiated rate, particularly for those with high-deductible plans.
This pricing data is specific to the facility's location in Kingman, KS (ZIP 67068), and does not include broader state or county average comparisons as those metrics were not provided in the available dataset. The facility operates as a voluntary non-profit Critical Access Hospital, and the rates reflect the specific contract dynamics between the provider and eight distinct payers, including Celtic Insurance Company, Wellcare, UnitedHealthcare, and Ambetter/Centene. Because commercial rates are often inflated by administrative processing costs and network tiering, patients should verify their specific plan's allowed amount before scheduling. If you receive a bill that appears higher than these negotiated figures, you may be eligible for an itemized billing audit to identify errors or unbundled charges, and you should never sign away your rights regarding out-of-network balance billing without