CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Duke University Hospital

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$33,074

about 1.4× the $23,504 Medicare rate · typically $16,668–$34,642

modeled estimate · not a bill or quote

What this hospital charges insurers

$34,175

About the fair price

about $1,101 over the fair price · 1.5× Medicare

Medicare pays $23,504 Fair price $33,074 This hospital $34,175 Cash price $15,970 Hospital's list price $59,149

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

Highest price of the 9 NC hospitals we have prices for — worth calling around.

Cheapest $20,910 Priciest $34,175

Black dot = this hospital, among the 9 NC hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $33,074 (about 1.4× the $23,504 Medicare rate). Duke University Hospital charges insurers about $34,175, or about $15,970 in cash — about the fair price. Located in Durham, NC.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$26,448 - $59,724	113%
Blue Cross Blue Shieldmajor	$26,448 - $44,147	113%
Aetnamajor	$8,025 - $30,521	34%
Cignamajor	$21,768 - $52,540	93%
Humanamajor	$18,140 - $24,912	77%
AmeriHealth	$34,175	145%
Sentara	$13,296	57%
+ 7 smaller / regional plans	$21,342 - $34,175

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,970), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm Duke University Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Duke University Hospital

Compare: Spinal fusion, single level (inpatient stay) at other NC hospitals

Haywood Regional Medical Center · Clyde $20,910
Frye Regional Medical Center · Hickory $20,986
Sentara Albemarle Medical Center · Elizabeth City $22,776
Hugh Chatham Memorial Hospital · Elkin $24,306
Ecu Health North Hospital · Roanoke Rapids $24,941
Vidant Roanoke Chowan Hospital · Ahoskie $25,525
Vidant Edgecombe Hospital · Tarboro $26,687
The McDowell Hospital · Marion $26,838

Insurance negotiated median for the same procedure, sorted lowest first.