CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Presbyterian Hospital

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$31,271

about 1.3× the $23,504 Medicare rate · typically $28,164–$37,317

modeled estimate · not a bill or quote

What this hospital charges insurers

$31,117

About the fair price

about $154 under the fair price · 1.3× Medicare

Medicare pays $23,504 Fair price $31,271 This hospital $31,117

How we calculate the fair BaseRate →

How this hospital compares to other NM hospitals

A typical price — 4 charge more and 4 charge less, among the 9 NM hospitals compared.

Cheapest $21,355 Priciest $35,908

Black dot = this hospital, among the 9 NM hospitals with a price for this procedure. Full list below.

A fair price for a Spinal fusion, single level (inpatient stay) is about $31,271 (about 1.3× the $23,504 Medicare rate). Presbyterian Hospital charges insurers about $31,117 — about the fair price. Located in Albuquerque, NM.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$25,983 - $53,171	111%
Blue Cross Blue Shieldmajor	$25,983 - $49,181	111%
Aetnamajor	$26,233 - $71,541	112%
Cignamajor	$26,233 - $44,540	112%
Presbyterian	$23,810 - $36,480	101%
+ 1 smaller / regional plan	$25,983

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm Presbyterian Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Presbyterian Hospital

Compare: Spinal fusion, single level (inpatient stay) at other NM hospitals

Alta Vista Regional Hospital · Las Vegas $21,355
Christus St Vincent Regional Medical Center · Santa Fe $21,654
Holy Cross Hospital A Div of Taos Health Systems · Taos $24,697
Covenant Health Hobbs Hospital · Hobbs $27,987
Artesia General Hospital · Artesia $32,124
Dr Dan C Trigg Memorial Hospital · Tucumcari $33,476
Lincoln County Medical Center · Ruidoso $33,476
UNM Hospital · Albuquerque $35,908

Insurance negotiated median for the same procedure, sorted lowest first.