CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Trinity Health Muskegon Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $34,401
  • Cash Discount Price: $53,050
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Trinity Health Muskegon Hospital is $34,401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53,050. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.46x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$53,050

Average discount available for prompt cash payment at this facility.

Insurance Median
$34,401

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: $53,050 (226%)
Insurance Median: $34,401 (146%)
Cash: $53,050 (226% of Medicare)
Ins. Median: $34,401 (146% 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
Access Health $17,200 73%
Aetna $24,080 - $53,715 102%
Blue Care Network Advantage $24,080 102%
Blue Cross Blue Shield $24,080 - $60,750 102%
Medicare (plans) $24,080 102%
Align Senior Care $24,571 105%
Correctional Recovery $24,571 105%
UnitedHealthcare $25,308 108%
Oscar $26,977 115%
Longevity Ipa Of Michigan Llc Health Plan Isnp $27,692 118%
Molina Marketplace $31,943 136%
Caresource $34,401 146%
Hap $34,401 146%
Priority Health $43,148 - $59,859 184%
U Of M Health Plan $45,313 193%
Geha $53,715 229%
Meritain $53,715 229%
Bcn Domestic $60,750 258%
Blue Benefit Administrators Of Massachusetts $60,750 258%
Blue Care Network $60,750 258%
Blue Distinction Transplant $60,750 258%
Blue Shield - Ca $60,750 258%
Blue Shield - Id (Regence) $60,750 258%
Blue Shield - Ny Highmark Northeastern $60,750 258%
Blue Shield - Ny Highmark Western $60,750 258%
Blue Shield - Pa (Highmark) $60,750 258%
Blue Shield - Wa (Regence) $60,750 258%
Health Choices $60,750 258%
Kaiser Domestic $60,750 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 E Sherman Blvd, Muskegon, MI 49441
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals