CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Mountainview Hospital

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $31,510
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Mountainview Hospital is $31,510. 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 1.34x the Medicare baseline. Located in 3100 N Tenaya Way, Las Vegas, NV.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$31,510

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: $31,510 (134%)

Ins. Median: $31,510 (134% 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
Sierra	$2,732 - $25,842	12%
Multiplan	$3,186	14%
First Health	$3,456	15%
Hometown Health Providers	$3,973 - $4,612	17%
Prominence Healthfirst	$4,095	17%
Health Services Coalition	$4,110	17%
Aetna	$4,158 - $32,445	18%
United	$5,006 - $34,098	21%
Cigna	$6,540 - $74,083	28%
Community Care Health	$17,900	76%
Procare	$30,390	129%
Hometown Health Mcr	$31,030	132%
Humana	$31,030 - $31,990	132%
Alignment Health Plan	$31,990	136%
Ambetter / Centene	$31,990 - $57,582	136%
Blue Cross Blue Shield	$31,990 - $62,098	136%
Select Health	$31,990 - $70,585	136%
Triwest Healthcare Alliance	$31,990	136%
UnitedHealthcare	$31,990	136%
Caremore	$32,630	139%
Imperial Nv	$33,589	143%
Universal Healthcare	$34,229	146%

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 Mountainview Hospital 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.