CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Carolinas Medical Center-Northeast

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $38,844
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Carolinas Medical Center-Northeast is $38,844. 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 1.65x the Medicare baseline. Located in 920 Church St N, Concord, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$38,844

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: $38,844 (165%)
Ins. Median: $38,844 (165% 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.

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 $24,284 103%
Aetna $24,641 105%
Cigna $24,998 - $55,234 106%
UnitedHealthcare $25,072 - $36,614 107%
Ambetter / Centene $33,162 - $41,754 141%
Amerihealth Caritas $38,127 162%
Carolina Complete Health $38,844 165%
Healthy Blue $38,844 165%
Partners $38,844 165%
Wellcare $38,844 165%
Vaya $39,232 167%
Alliance $39,621 169%
Trillium $40,009 170%
Blue Cross Blue Shield $45,938 - $60,445 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 920 Church St N, Concord, NC 28025
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals