CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Englewood Hospital and Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $30,607
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Englewood Hospital and Medical Center is $30,607. 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 1.30x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$30,607

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: $30,607 (130%)
Ins. Median: $30,607 (130% 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 $10,187 - $29,861 43%
Hip Health Plan $26,874 - $27,472 114%
Aetna $29,861 - $51,409 127%
Americhoice_732 $29,861 127%
Amerigroup_758 $29,861 127%
Amerihealth_766 $29,861 127%
Clover_733 $29,861 127%
Emblem_734 $29,861 127%
Horizon New Jersey Health - Dsnp $29,861 127%
Humana $29,861 127%
Health Care Support_787 $31,354 133%
Wellcare_765 $32,249 137%
Magnacare $32,491 138%
Magnacare_763 $42,066 179%
Magnacare_769 $48,430 206%
Oxford_741 $54,878 233%
UnitedHealthcare $54,878 - $55,482 233%
Cigna $55,386 236%
Amerihealth_757 $62,821 267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 Engle St, Englewood, NJ 07631
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals