CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Elizabeth Edgewood

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$31,206

about 1.3× the $23,504 Medicare rate · typically $25,843–$37,975

modeled estimate · not a bill or quote

What this hospital charges insurers

$26,168

Below the fair price — a good deal

about $5,038 under the fair price · 1.1× Medicare

Medicare pays $23,504 Fair price $31,206 This hospital $26,168

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $21,483 Priciest $26,168

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $31,206 (about 1.3× the $23,504 Medicare rate). St Elizabeth Edgewood charges insurers about $26,168 — below the fair price — a good deal. Located in Edgewood, KY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$25,063 - $79,665	107%
Blue Cross Blue Shieldmajor	$22,409 - $82,146	95%
Aetnamajor	$77,685	331%
Cignamajor	$84,365	359%
Humanamajor	$24,571	105%
Ambetter (Centene)	$49,143	209%
CareSource	$24,571 - $49,143	105%
Cigna HealthSpring	$24,571	105%
Devoted Health	$25,800	110%
Molina	$24,571	105%
WellCare	$26,537	113%
+ 2 smaller / regional plans	$24,571 - $60,691

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm St Elizabeth Edgewood is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Elizabeth Edgewood

Compare: Spinal fusion, single level (inpatient stay) at other KY hospitals

Georgetown Community Hospital · Georgetown $21,483
Saint Joseph London · London $21,694
Clark Regional Medical Center · Winchester $22,075
Saint Joseph Hospital · Lexington $22,383
Tristar Greenview Regional Hospital · Bowling Green $22,390
Harrison Memorial Hospital · Cynthiana $22,989
Frankfort Regional Medical Center · Frankfort $23,774
Saint Joseph East · Lexington $23,844

Insurance negotiated median for the same procedure, sorted lowest first.