CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Wilkes Regional Medical Center

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$35,423

about 1.5× the $23,504 Medicare rate · typically $27,552–$45,495

modeled estimate · not a bill or quote

What this hospital charges insurers

$45,500

Above the fair price

about $10,077 over the fair price · 1.9× Medicare

Medicare pays $23,504 Fair price $35,423 This hospital $45,500

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 $45,500

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 $35,423 (about 1.5× the $23,504 Medicare rate). Wilkes Regional Medical Center charges insurers about $45,500 — above the fair price. Located in North Wilkesboro, NC.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $35,423. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare Blue Cross Blue ShieldAetnaCignaHumanaKaiser 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	$45,726	195%
AmeriHealth	$45,273	193%
WellCare	$45,726	195%
+ 7 smaller / regional plans	$23,078 - $46,632

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, 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 Wilkes Regional Medical Center 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 Wilkes Regional Medical Center

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.