CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Jacobi Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 451
  • Insurance Median: $45,277
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Jacobi Medical Center is $45,277. 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 1.93x the Medicare baseline. Located in 1400 Pelham Parkway South, Bronx, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$45,277

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: $45,277 (193%)
Ins. Median: $45,277 (193% 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
Healthfirst $42,108 179%
Centerlight $44,372 189%
Aetna $45,277 - $68,762 193%
Blue Cross Blue Shield $45,277 193%
Elderplan $45,277 193%
Emblem $45,277 - $59,014 193%
Fidelis $45,277 - $64,294 193%
Hamaspik $45,277 193%
Oxford $45,277 - $81,798 193%
Senior Whole Health $45,277 193%
Vaccn $45,277 193%
Vnsny $45,277 193%
Wellcare $45,957 196%
Metroplus $46,636 198%
Centers Plan For Healthy Living $47,088 200%
Villagecare Max $51,163 218%
Multiplan $80,128 341%
United $101,048 430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 Pelham Parkway South, Bronx, NY 10461
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals