CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: PAM Health Specialty Hospital of Stoughton

Billing Code: 451 (MS-DRG)

The BaseRate · fair price medium confidence

A fair price for this

$46,094

about 2.0× the $23,504 Medicare rate · typically $17,084–$55,178

modeled estimate · not a bill or quote

What this hospital charges insurers

$38,005

Below the fair price — a good deal

about $8,089 under the fair price · 1.6× Medicare

Medicare pays $23,504 Fair price $46,094 This hospital $38,005

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

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

Cheapest $23,031 Priciest $38,005

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

A fair price for a Spinal fusion, single level (inpatient stay) is about $46,094 (about 2.0× the $23,504 Medicare rate). PAM Health Specialty Hospital of Stoughton charges insurers about $38,005 — below the fair price — a good deal. Located in Stoughton, MA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna Blue Cross Blue ShieldCignaHumanaKaiser 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	$38,005	162%
Aetnamajor	$38,005	162%
Harvard Pilgrim	$38,005	162%
Health Net	$38,385	163%
Tufts Health Plan	$38,005	162%
+ 3 smaller / regional plans	$38,005

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 PAM Health Specialty Hospital of Stoughton 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 PAM Health Specialty Hospital of Stoughton

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

Beth Israel Deaconess Hospital - Milton · Milton $23,031
Newton-Wellesley Hospital · Newton $27,428
Winchester Hospital · Winchester $27,661
Anna Jaques Hospital · Newburyport $27,865
Melrosewakefield Healthcare · Melrose $28,022
Beth Israel Deaconess Hospital Plymouth · Plymouth $28,349
South Shore Hospital · South Weymouth $28,491
Brown University Health Morton Hospital · Taunton $28,595

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