CMS Price Transparency Data
Spinal fusion, single level (inpatient stay)
Facility: Mercy Hospital Springfield
Billing Code: 451 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 451
- Insurance Median: $26,887
- Cash Discount Price: $51,422
- vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Mercy Hospital Springfield is $26,887. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51,422. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.14x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$51,422
Average discount available for prompt cash payment at this facility.
Insurance Median
$26,887
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: $51,422 (219%)
Insurance Median: $26,887 (114%)
Cash: $51,422 (219% of Medicare)
Ins. Median: $26,887 (114% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Multiplan Contracted [320270] | $3,765 | 16% |
| Private Health Care Systems Contracted [320320] | $3,765 | 16% |
| UnitedHealthcare | $3,765 - $46,091 | 16% |
| Ambetter / Centene | $3,891 | 17% |
| Home State Health Plan Contracted [320187] | $3,891 | 17% |
| Medicaid / KanCare | $3,891 - $13,687 | 17% |
| Novasys Contracted [320285] | $3,891 | 17% |
| Aetna | $12,081 - $35,089 | 51% |
| Humana | $12,081 - $27,297 | 51% |
| Blue Cross Blue Shield | $13,421 - $33,302 | 57% |
| Point C Contracted [320238] | $23,062 - $31,017 | 98% |
| Evolutions Health Care Contracted [320124] | $24,115 | 103% |
| Providrs Care Network Contracted [320484] | $25,197 | 107% |
| Centivo Contracted [320505] | $25,431 | 108% |
| Centurion Of Missouri [20459] | $25,431 | 108% |
| Champva [20065] | $25,431 | 108% |
| Cherokee Nation Health Serv Contracted [320066] | $25,431 | 108% |
| Cigna | $25,431 - $38,477 | 108% |
| Cross Timbers Hospice [20098] | $25,431 | 108% |
| Dept Of Veteran Affairs Contracted [320106] | $25,431 | 108% |
| Elara Caring Aspire Hospice [20433] | $25,431 | 108% |
| Globalhealth Contracted [320145] | $25,431 | 108% |
| Halo Hcr Inc Hospice Contracted [320432] | $25,431 | 108% |
| Halo Hcr Inc Hospice [20432] | $25,431 | 108% |
| Indian Health Service Contracted [320198] | $25,431 | 108% |
| Indian Health Service [20198] | $25,431 | 108% |
| Kindful Hospice Contracted [320434] | $25,431 | 108% |
| Kindful Hospice [20434] | $25,431 | 108% |
| Medicare (plans) | $25,431 - $26,220 | 108% |
| Mercy Hospice Okc [20252] | $25,431 | 108% |
| Mercy Mgd Behavioral Health Contracted [320259] | $25,431 | 108% |
| Mercy Rehab Hospital Contracted [320260] | $25,431 | 108% |
| Pace Of The Ozarks Contracted [320518] | $25,431 | 108% |
| Qual Choice Contracted [320325] | $25,431 | 108% |
| Federal Medical Center Contracted [320127] | $26,497 | 113% |
| Mercy Benefit Admin Contracted [320251] | $26,887 - $29,836 | 114% |
| Provider Partners Health Plans Contracted [320450] | $27,491 | 117% |
| Benefit Management Contracted [320052] | $27,814 | 118% |
| 90 Degree Benefits Contracted [320436] | $28,415 | 121% |
| Show-Me Health Administrators Contracted [320483] | $28,415 - $29,836 | 121% |
| Aither Health Contracted [320449] | $28,524 | 121% |
| Auxiant Contracted [320462] | $28,524 | 121% |
| Ebms Contracted [320493] | $28,524 | 121% |
| Edison Health Solutions Contracted [320502] | $28,524 | 121% |
| Healthlink Contracted [320179] | $28,524 - $34,979 | 121% |
| Imagine 360 Contracted [320494] | $28,524 | 121% |
| Reflect Health Contracted [320492] | $28,524 | 121% |
| Yuzu Health Contracted [320521] | $28,524 | 121% |
| Health Systems Inc Contracted [320174] | $28,647 | 122% |
| Insurance System Inc Contracted [320465] | $28,647 | 122% |
| Point C [20238] | $28,859 | 123% |
| Medica Contracted [320239] | $29,555 | 126% |
| Medica [20239] | $29,555 | 126% |
| Tricare | $30,010 | 128% |
| Healthscope Contracted [320182] | $31,306 | 133% |
| United Medical Resources Contracted [320454] | $34,145 | 145% |
| First Health Contracted [320128] | $34,481 | 147% |