Spinal fusion, single level (inpatient stay) cost in MT
What a spinal fusion, single level (inpatient stay) costs at MT hospitals — and the fair price to aim for.
Typical commercial prices here are 15% below the fair benchmark (0.85×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Uniform Value Leader · Low-Cost Across Departments
This hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.3× Medicare, p50 0.74× Fair BaseRate) and emergency/ancillary services (1.3× Medicare, p75 0.76× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 26% below peer Fair BaseRate (0.74×)
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- CMS clinical safety score (66/100 safety score) with 68% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
- Commercial insurance median sits at 0.74× Fair BaseRate (1.3× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.5× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 5,686) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
In general, MT hospitals charge about the fair price for this. how we calculate the BaseRate →
Compared with the rest of the country, MT’s fair BaseRate ($26,199) is about the same as the national fair price of $30,786.
Cheapest MT hospitals for a spinal fusion, single level (inpatient stay)
- Community Medical Center · Missoula $22,522
- St Peters Health · Helena $25,236
- Logan Health Medical Center · Kalispell $26,168
- St. Patrick Hospital · Missoula $26,824
- Great Falls Clinic Hospital · Great Falls $45,222
Audit a Bill or Quote at MT Hospital Benchmark (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $22,797
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $22,797).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask MT Hospital Benchmark's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $26,199 Fair BaseRate ($15,195 Medicare)
Your bill ($62,803) is $36,604 above the denoised Fair BaseRate ($26,199) and 4.1× the $15,195 Medicare rate.