CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Good Samaritan Hospital of Suffern

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $42,802
Cash Discount Price: $43,266
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Good Samaritan Hospital of Suffern is $42,802. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43,266. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.82x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.

Cash / Self-Pay

$43,266

Average discount available for prompt cash payment at this facility.

Insurance Median

$42,802

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%)

Cash / Self-Pay: $43,266 (184%)

Insurance Median: $42,802 (182%)

Cash: $43,266 (184% of Medicare)

Ins. Median: $42,802 (182% 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
Multiplan	$5,836	25%
Aetna	$28,844 - $89,204	123%
Blue Cross Blue Shield	$28,844	123%
Cdphp	$28,844	123%
Emblem	$28,844 - $125,746	123%
Fidelis	$28,844	123%
Geisinger	$28,844 - $65,475	123%
Hamaspik	$28,844	123%
Magnacare	$28,844 - $117,399	123%
Mvp	$28,844 - $100,288	123%
Non Contracted	$28,844	123%
Oxford	$28,844 - $83,101	123%
Partners Health Plan	$28,844	123%
UnitedHealthcare	$28,844 - $83,101	123%
Wellcare	$28,844	123%
Health First	$30,863	131%
Tricare	$37,439	159%
World Trade Center	$42,802	182%
Cigna	$95,620	407%

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 $43,266.
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 Good Samaritan Hospital of Suffern 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.