CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Saint Joseph Mount Sterling

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$26,035

about 1.1× the $23,504 Medicare rate · typically $20,848–$26,035

modeled estimate · not a bill or quote

What this hospital charges insurers

$25,050

About the fair price

about $985 under the fair price · 1.1× Medicare

Medicare pays $23,504 Fair price $26,035 This hospital $25,050

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 $25,050

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 $26,035 (about 1.1× the $23,504 Medicare rate). Saint Joseph Mount Sterling charges insurers about $25,050 — about the fair price. Located in Mount Sterling, KY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$23,915 - $31,588	102%
Blue Cross Blue Shieldmajor	$24,618 - $33,545	105%
Aetnamajor	$21,101 - $25,420	90%
Humanamajor	$23,446 - $30,306	100%
CareSource	$49,360	210%
Molina	$23,915 - $25,914	102%
WellCare	$23,915 - $24,680	102%

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 Saint Joseph Mount Sterling 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 Saint Joseph Mount Sterling

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.