CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Caromont Regional Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $38,331
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Caromont Regional Medical Center is $38,331. 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 1.63x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$38,331

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: $38,331 (163%)
Ins. Median: $38,331 (163% 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
Blue Cross Blue Shield $25,121 - $63,251 107%
UnitedHealthcare $25,121 107%
Aetna $26,126 - $63,590 111%
Devoted Health $26,377 112%
Healthteam $26,377 112%
Humana $26,377 112%
Longevity Health $26,377 112%
Molina $26,377 112%
Carolina Complete Health $37,579 160%
Alliance Behavioral Health $38,331 163%
Amerihealth Caritas $38,331 163%
Carolina Complete Health Tailored Plans $38,331 163%
Vaya Behavioral Health $38,331 163%
Wellcare $38,331 163%
Corporate Benefits Service $46,172 196%
Cigna $46,725 - $65,173 199%
Carolina Caring $62,803 267%
Gaston County Jail $75,158 320%
Medcost $77,665 330%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2525 Court Dr, Gastonia, NC 28052
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals