CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Jfk University Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $28,464
  • Cash Discount Price: $26,942
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Jfk University Medical Center is $28,464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26,942. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.21x the Medicare baseline. Located in 65 James Street, Edison, NJ.
Cash / Self-Pay
$26,942

Average discount available for prompt cash payment at this facility.

Insurance Median
$28,464

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: $26,942 (115%)
Insurance Median: $28,464 (121%)
Cash: $26,942 (115% of Medicare)
Ins. Median: $28,464 (121% 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
Horizon $6,947 - $27,369 30%
Vaccn $26,942 115%
Aetna $27,369 - $74,681 116%
Amerigroup $27,369 116%
Blue Cross Blue Shield $27,369 116%
Wellcare $27,369 116%
United Community/Americhoice $28,738 122%
Clover $30,106 128%
Seoul Medical Group $30,654 130%
Karna $38,168 162%
Cigna $87,698 - $97,033 373%
Oxford $111,605 475%
UnitedHealthcare $132,099 562%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 65 James Street, Edison, NJ 08818
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals