CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Palisades Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $39,908
Cash Discount Price: $37,134
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Palisades Medical Center is $39,908. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37,134. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.70x the Medicare baseline. Located in 7600 River Rd, North Bergen, NJ.

Cash / Self-Pay

$37,134

Average discount available for prompt cash payment at this facility.

Insurance Median

$39,908

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%)

Cash / Self-Pay: $37,134 (158%)

Insurance Median: $39,908 (170%)

Cash: $37,134 (158% of Medicare)

Ins. Median: $39,908 (170% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Horizon	$11,497 - $36,612	49%
Aetna	$36,612 - $76,875	156%
Amerigroup	$36,612	156%
Blue Cross Blue Shield	$36,612	156%
Wellcare	$36,612	156%
Vaccn	$37,134	158%
Clover	$40,274	171%
Seoul Medical Group	$41,006	174%
Karna	$50,492	215%
Cigna	$70,524 - $79,702	300%
Oxford	$97,817	416%
UnitedHealthcare	$116,601	496%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $37,134.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Palisades Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.