CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: University of Michigan Health - West

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $38,996
Cash Discount Price: $156,655
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at University of Michigan Health - West is $38,996. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156,655. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.66x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$156,655

Average discount available for prompt cash payment at this facility.

Insurance Median

$38,996

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: $156,655 (667%)

Insurance Median: $38,996 (166%)

Cash: $156,655 (667% of Medicare)

Ins. Median: $38,996 (166% 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
Care Resources	$18,014	77%
Aetna	$20,016 - $40,596	85%
Humana	$20,016 - $22,177	85%
Medicare (plans)	$20,016	85%
Molina Marketplace Commercial	$20,016	85%
Insight Metro Care	$28,823	123%
Golden Rule Ins	$35,720	152%
Medica	$35,720	152%
Student Ins/Mega Life	$35,720	152%
UnitedHealthcare	$35,720	152%
Apwu	$38,996	166%
Cigna	$38,996	166%
Health Partners	$38,996	166%
Priority Health	$38,996	166%
Web Tpa	$38,996	166%
Bcn	$51,808	220%
Blue Cross Blue Shield	$51,808	220%
Alliance Health & Life Ppo	$262,397	1116%
Asr Physicians	$262,397	1116%
Hap	$262,397	1116%
Asr Cofinity	$327,017	1391%
Cofinity Commercial	$327,017	1391%
Cofinity Weyco	$327,017	1391%
Core Source	$327,017	1391%
Epoch Group	$327,017	1391%
Hlthcomp Admin	$327,017	1391%
Mid America	$327,017	1391%

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 $156,655.
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 University of Michigan Health - West 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.