CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Cooperman Barnabas Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $42,927
Cash Discount Price: $3,319
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Cooperman Barnabas Medical Center is $42,927. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,319. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.83x the Medicare baseline. Located in 94 Old Short Hills Road, Livingston, NJ.

Cash / Self-Pay

$3,319

Average discount available for prompt cash payment at this facility.

Insurance Median

$42,927

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: $3,319 (14%)

Insurance Median: $42,927 (183%)

Cash: $3,319 (14% of Medicare)

Ins. Median: $42,927 (183% 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
Blue Cross Blue Shield	$6,765 - $28,996	29%
Aetna	$28,996 - $83,632	123%
Clover Health	$28,996	123%
Fidelis Care	$28,996	123%
Humana	$28,996	123%
Wellpoint	$28,996	123%
UnitedHealthcare	$29,576 - $83,476	126%
Emblem Health	$56,279	239%
Wellcare	$57,702	245%
Cigna	$68,954 - $72,626	293%

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 $3,319.
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 Cooperman Barnabas 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.