CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Sunrise Hospital and Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $26,830
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Sunrise Hospital and Medical Center is $26,830. 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 1.14x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$26,830

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: $26,830 (114%)

Ins. Median: $26,830 (114% 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
Humana	$2,368 - $29,145	10%
Sierra	$2,680 - $25,461	11%
Multiplan	$3,186	14%
Nevada Preferred Professionals	$3,269	14%
First Health	$3,456	15%
Select Health	$3,588 - $70,585	15%
United	$3,592 - $34,275	15%
Hometown Health Providers	$3,784 - $4,612	16%
Health Services Coalition	$3,896 - $4,110	17%
Prominence Healthfirst	$4,095	17%
Aetna	$4,164 - $46,751	18%
Cigna	$4,327 - $74,083	18%
Community Care Health	$17,900	76%
Hometown Health Mcr	$26,983 - $28,271	115%
Alignment Health Plan	$27,818 - $29,145	118%
Ambetter / Centene	$27,818 - $52,461	118%
Blue Cross Blue Shield	$27,818 - $62,098	118%
Triwest Healthcare Alliance	$27,818 - $29,145	118%
Caremore	$28,374 - $29,728	121%
Imperial Nv	$29,209 - $30,603	124%
Universal Healthcare	$29,765 - $31,185	127%

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 $X.
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 Sunrise Hospital and 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.