CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: St Lukes Hospital of Kansas City

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $37,990
Cash Discount Price: $87,082
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at St Lukes Hospital of Kansas City is $37,990. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87,082. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.62x the Medicare baseline. Located in 4401 Wornall Road, Kansas City, MO.

Cash / Self-Pay

$87,082

Average discount available for prompt cash payment at this facility.

Insurance Median

$37,990

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: $87,082 (370%)

Insurance Median: $37,990 (162%)

Cash: $87,082 (370% of Medicare)

Ins. Median: $37,990 (162% 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
Cigna	$2,400 - $45,287	10%
Blue Cross Blue Shield	$4,600 - $103,340	20%
Commercial-Contracted [8000]	$4,758 - $44,877	20%
Medicaid / KanCare	$13,421 - $14,763	57%
Medicare (plans)	$25,176 - $26,434	107%
Transplants-Case Rates [5750]	$25,176 - $100,213	107%
UnitedHealthcare	$38,729 - $69,809	165%
Aetna	$53,276 - $100,213	227%

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 $87,082.
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 St Lukes Hospital of Kansas City 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.