CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: PAM Health Specialty Hospital of Reno

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $32,053
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at PAM Health Specialty Hospital of Reno is $32,053. 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 1.36x the Medicare baseline. Located in 235 W 6Th St, Reno, NV.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$32,053

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: $32,053 (136%)
Ins. Median: $32,053 (136% 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
Aetna $32,053 136%
Alignment Health $32,053 136%
Atrio Health Plan $32,053 136%
Blue Cross Blue Shield $32,053 136%
Healthchoice $32,053 136%
Hometown Health $32,053 136%
Humana $32,053 136%
Ilumed Aco Reach $32,053 136%
Premier Health $32,053 136%
Prominence Health Plan $32,053 136%
Select Health $32,053 136%
Imperial Health $33,655 - $40,066 143%
Molina $35,258 150%
Silver Summit $35,899 153%
Velocity Provider Ppo Network $38,463 164%
Prime Health Services $41,668 - $48,079 177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 235 W 6Th St, Reno, NV 89503
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL