CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Lake Cumberland Regional Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $24,214
  • Cash Discount Price: $62,554
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Lake Cumberland Regional Hospital is $24,214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62,554. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.03x the Medicare baseline. Located in 305 Langdon Street, Somerset, KY.
Cash / Self-Pay
$62,554

Average discount available for prompt cash payment at this facility.

Insurance Median
$24,214

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$23,503.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $23,503.93 (100%)
Cash / Self-Pay: $62,554 (266%)
Insurance Median: $24,214 (103%)
Cash: $62,554 (266% of Medicare)
Ins. Median: $24,214 (103% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $3,196 - $24,698 14%
Aetna $22,999 98%
Devoted Health $22,999 98%
Blue Cross Blue Shield $24,214 - $41,068 103%
Definity $24,214 103%
Humana $24,214 103%
Pyramid $24,214 103%
Secure Horizons $24,214 103%
Sterling $24,214 103%
Unicare $24,214 103%
Bluegrass Family Health $24,698 105%
Amerigroup $25,425 108%
Tricare $33,805 144%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 305 Langdon Street, Somerset, KY 42503
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals