CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Ochsner Medical Center - Baton Rouge

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $37,075
Cash Discount Price: $33,778
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Ochsner Medical Center - Baton Rouge is $37,075. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33,778. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.58x the Medicare baseline. Located in 17000 Medical Center Dr, Baton Rouge, LA.

Cash / Self-Pay

$33,778

Average discount available for prompt cash payment at this facility.

Insurance Median

$37,075

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: $33,778 (144%)

Insurance Median: $37,075 (158%)

Cash: $33,778 (144% of Medicare)

Ins. Median: $37,075 (158% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$18,954	81%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$21,825	93%
Blue Cross Blue Shield	$21,825 - $44,040	93%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$21,825	93%
Humana	$21,825	93%
Medicare (plans)	$21,825	93%
Ochsner Health Plan	$21,825	93%
UnitedHealthcare	$21,825 - $57,822	93%
Tricare	$27,146	115%
Aetna	$34,424	146%
Cigna	$37,853	161%
Louisiana Workers' Compensation Corporation (Lwcc)	$58,056	247%
Healthcomp & Personify Health (Formerly Gilsbar)	$63,334	269%
Mississippi Physicians Care Network	$79,168	337%
Prime Health Services Ppo	$89,723	382%
Usa Managed Care Network	$89,723	382%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $33,778.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Medical Center - Baton Rouge is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.