CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Carolinas Medical Center/Behav Health

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $36,903
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Carolinas Medical Center/Behav Health is $36,903. 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 1.57x the Medicare baseline. Located in 1000 Blythe Blvd, Charlotte, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$36,903

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: $36,903 (157%)
Ins. Median: $36,903 (157% 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 $13,221 - $59,415 56%
Humana $29,988 128%
Aetna $30,429 129%
Cigna $30,870 - $55,234 131%
UnitedHealthcare $30,961 - $34,785 132%
Ambetter / Centene $33,162 - $41,754 141%
Amerihealth Caritas $36,221 - $37,272 154%
Carolina Complete Health $36,903 157%
Healthy Blue $36,903 157%
Partners $36,903 157%
Wellcare $36,903 157%
Trillium $36,939 - $38,010 157%
Vaya $37,272 159%
Alliance $37,641 160%
Molina $37,873 - $40,318 161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Blythe Blvd, Charlotte, NC 28203
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals