CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Garnet Health Medical Center

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$37,496

about 1.6× the $23,504 Medicare rate · typically $27,971–$61,008

modeled estimate · not a bill or quote

What this hospital charges insurers

$34,442

About the fair price

about $3,054 under the fair price · 1.5× Medicare

Medicare pays $23,504 Fair price $37,496 This hospital $34,442

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $24,445 Priciest $34,442

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

A fair price for a Spinal fusion, single level (inpatient stay) is about $37,496 (about 1.6× the $23,504 Medicare rate). Garnet Health Medical Center charges insurers about $34,442 — about the fair price. Located in Middletown, NY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$34,442 - $100,375	147%
Blue Cross Blue Shieldmajor	$34,442	147%
Aetnamajor	$34,442 - $96,912	147%
Cignamajor	$34,442 - $97,587	147%
Humanamajor	$34,442	147%
CDPHP	$34,442 - $119,250	147%
Fidelis Care	$35,131	149%
Geisinger	$34,442 - $77,495	147%
MagnaCare	$124,984	532%
MVP Health Care	$34,442	147%
UPMC Health Plan	$34,442	147%
WellCare	$34,959	149%
+ 4 smaller / regional plans	$34,442 - $118,352

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 Garnet Health Medical Center 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 Garnet Health Medical Center

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

Chsli St Joseph Hospital · Bethpage $24,445
Glens Falls Hospital · Glens Falls $24,938
Montefiore St Luke's Cornwall · Newburgh $26,391
Montefiore New Rochelle Hospital · New Rochelle $26,514
Montefiore Mount Vernon Hospital · Mount Vernon $27,008
St Francis Hospital - the Heart Center · Roslyn $27,323
Geneva General Hospital · Geneva $28,073
Mercy Medical Center · Rockville Centre $28,436

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