CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Henry Ford Health St John Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $25,003
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Henry Ford Health St John Hospital is $25,003. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.06x the Medicare baseline. Located in 22101 Moross Rd, Detroit, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,003

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%)

Insurance Median: $25,003 (106%)

Ins. Median: $25,003 (106% 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
Humana	$8,400 - $25,253	36%
Aetna	$9,410 - $25,003	40%
Phcs Pos	$9,410	40%
Phcs Ppo	$9,410	40%
UnitedHealthcare	$10,828	46%
Medicare (plans)	$23,753 - $26,253	101%
Amerihealth Vip Care	$24,753	105%
Harbor Advantage Hmo	$25,003	106%
Tricare	$25,003	106%
Veterans Choice	$25,003	106%
Meridian Wellcare	$26,253	112%
Molina Advantage	$26,253	112%
Molina Health Link	$26,253	112%
Ambetter / Centene	$31,254	133%
Molina Market Place	$31,254	133%
Smarthealth	$35,004	149%
Aaa-Auto Insurance	$47,506	202%

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 $X.
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 Henry Ford Health St John Hospital 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.